diff --git a/admin/src/api/tcm.ts b/admin/src/api/tcm.ts
index 34204da8..42303f29 100644
--- a/admin/src/api/tcm.ts
+++ b/admin/src/api/tcm.ts
@@ -319,8 +319,13 @@ export function prescriptionEdit(params: any) {
     return request.post({ url: '/tcm.prescription/edit', params })
 }
 
-/** 仅修正处方笺患者姓名与手机号（不改审核状态），写入业务订单日志表 */
-export function prescriptionPatchPatient(params: { id: number; patient_name: string; phone: string }) {
+/** 仅修正处方笺患者姓名、手机号与性别（不改审核状态），写入业务订单日志表 */
+export function prescriptionPatchPatient(params: {
+    id: number
+    patient_name: string
+    phone: string
+    gender: number
+}) {
     return request.post({ url: '/tcm.prescription/patchPatient', params })
 }
 
diff --git a/admin/src/views/consumer/prescription/index.vue b/admin/src/views/consumer/prescription/index.vue
index da4aa206..1276666a 100644
--- a/admin/src/views/consumer/prescription/index.vue
+++ b/admin/src/views/consumer/prescription/index.vue
@@ -992,7 +992,7 @@
         <!-- 修正处方笺姓名 / 手机号（zyt_tcm_prescription，写入订单日志） -->
         <el-dialog
             v-model="patchPatientVisible"
-            title="修正处方姓名与手机号"
+            title="修正姓名、性别与手机号"
             width="440px"
             :close-on-click-modal="false"
             destroy-on-close
@@ -1010,12 +1010,18 @@
                 <el-form-item label="患者姓名" prop="patient_name">
                     <el-input v-model="patchPatientForm.patient_name" maxlength="50" show-word-limit placeholder="处方笺展示姓名" />
                 </el-form-item>
+                <el-form-item label="性别" prop="gender">
+                    <el-radio-group v-model="patchPatientForm.gender">
+                        <el-radio :label="1">男</el-radio>
+                        <el-radio :label="0">女</el-radio>
+                    </el-radio-group>
+                </el-form-item>
                 <el-form-item label="手机号" prop="phone">
                     <el-input v-model="patchPatientForm.phone" maxlength="20" placeholder="处方笺展示手机号" />
                 </el-form-item>
             </el-form>
             <p class="text-xs text-gray-500 -mt-2 mb-2">
-                仅更新处方表 patient_name、phone，不改变审核状态；记录写入业务订单操作日志（有关联订单时可在此订单日志中查看）。
+                仅更新处方表 patient_name、gender、phone，不改变审核状态；记录写入业务订单操作日志（有关联订单时可在此订单日志中查看）。
             </p>
             <template #footer>
                 <el-button @click="patchPatientVisible = false">取消</el-button>
@@ -1584,16 +1590,20 @@ const patchPatientFormRef = ref<FormInstance>()
 const patchPatientForm = reactive({
     id: 0,
     patient_name: '',
+    gender: 1 as 0 | 1,
     phone: ''
 })
 const patchPatientRules: FormRules = {
     patient_name: [{ required: true, message: '请输入患者姓名', trigger: 'blur' }],
+    gender: [{ required: true, message: '请选择性别', trigger: 'change' }],
     phone: [{ required: true, message: '请输入手机号', trigger: 'blur' }]
 }
 
 function openPatchPatientDialog(row: Record<string, unknown>) {
     patchPatientForm.id = Number(row.id) || 0
     patchPatientForm.patient_name = String(row.patient_name ?? '').trim()
+    const g = Number(row.gender)
+    patchPatientForm.gender = g === 0 || g === 1 ? (g as 0 | 1) : 1
     patchPatientForm.phone = String(row.phone ?? '').trim()
     patchPatientVisible.value = true
 }
@@ -1601,6 +1611,7 @@ function openPatchPatientDialog(row: Record<string, unknown>) {
 function resetPatchPatientForm() {
     patchPatientForm.id = 0
     patchPatientForm.patient_name = ''
+    patchPatientForm.gender = 1
     patchPatientForm.phone = ''
     patchPatientFormRef.value?.clearValidate()
 }
@@ -1618,7 +1629,8 @@ async function submitPatchPatient() {
         await prescriptionPatchPatient({
             id: patchPatientForm.id,
             patient_name: patchPatientForm.patient_name.trim(),
-            phone: patchPatientForm.phone.trim()
+            phone: patchPatientForm.phone.trim(),
+            gender: patchPatientForm.gender
         })
         feedback.msgSuccess('已保存')
         patchPatientVisible.value = false
diff --git a/admin/src/views/consumer/prescription/order_list.vue b/admin/src/views/consumer/prescription/order_list.vue
index ba1556f1..bdae4144 100644
--- a/admin/src/views/consumer/prescription/order_list.vue
+++ b/admin/src/views/consumer/prescription/order_list.vue
@@ -495,7 +495,7 @@
                             >修改单号</el-button>
                             <el-button
                                 v-if="canShipRow(row)"
-                                v-perms="['tcm.prescriptionOrder/ship']"
+                                v-perms="['tcm.prescriptionOrder/ship', 'tcm.prescriptionOrder/submitGancaoRecipel']"
                                 type="primary"
                                 link
                                 @click="openShip(row)"
@@ -606,7 +606,7 @@
                         </el-button>
                         <el-button
                             v-if="canShipRow(detailData)"
-                            v-perms="['tcm.prescriptionOrder/ship']"
+                            v-perms="['tcm.prescriptionOrder/ship', 'tcm.prescriptionOrder/submitGancaoRecipel']"
                             type="primary"
                             size="small"
                             plain
@@ -1917,6 +1917,15 @@
             :close-on-click-modal="false"
         >
             <el-alert
+                v-if="shipForm.ship_mode === 'gancao'"
+                title="甘草药方由甘草侧履约配送，无需填写快递单号。点击下方按钮将提交处方至甘草药管家（与「上传药方」相同）。"
+                type="info"
+                :closable="false"
+                show-icon
+                class="mb-4"
+            />
+            <el-alert
+                v-else
                 title="确认后订单状态将变更为「已发货」，请核对快递信息无误。"
                 type="warning"
                 :closable="false"
@@ -1930,27 +1939,33 @@
                         <el-radio label="direct">药房直发</el-radio>
                     </el-radio-group>
                 </el-form-item>
-                <el-form-item label="承运商">
-                    <el-select v-model="shipForm.express_company" class="w-full">
-                        <el-option label="自动识别" value="auto" />
-                        <el-option label="顺丰速运" value="sf" />
-                        <el-option label="京东快递" value="jd" />
-                        <el-option label="极兔速递" value="jt" />
-                    </el-select>
-                </el-form-item>
-                <el-form-item label="快递单号">
-                    <el-input
-                        v-model="shipForm.tracking_number"
-                        maxlength="80"
-                        placeholder="请输入快递单号"
-                        clearable
-                    />
-                </el-form-item>
+                <template v-if="shipForm.ship_mode === 'direct'">
+                    <el-form-item label="承运商">
+                        <el-select v-model="shipForm.express_company" class="w-full">
+                            <el-option label="自动识别" value="auto" />
+                            <el-option label="顺丰速运" value="sf" />
+                            <el-option label="京东快递" value="jd" />
+                            <el-option label="极兔速递" value="jt" />
+                        </el-select>
+                    </el-form-item>
+                    <el-form-item label="快递单号">
+                        <el-input
+                            v-model="shipForm.tracking_number"
+                            maxlength="80"
+                            placeholder="请输入快递单号"
+                            clearable
+                        />
+                    </el-form-item>
+                </template>
             </el-form>
             <template #footer>
                 <el-button @click="shipVisible = false">取消</el-button>
-                <el-button type="primary" :loading="shipSaving" @click="submitShip">
-                    确认发货
+                <el-button
+                    type="primary"
+                    :loading="shipSaving || (shipForm.ship_mode === 'gancao' && gancaoSubmitId === shipRowId)"
+                    @click="submitShip"
+                >
+                    {{ shipForm.ship_mode === 'gancao' ? '确认并上传药方' : '确认发货' }}
                 </el-button>
             </template>
         </el-dialog>
@@ -2589,6 +2604,7 @@ import { getDictData } from '@/api/app'
 import { deptAll } from '@/api/org/department'
 import { usePaging } from '@/hooks/usePaging'
 import feedback from '@/utils/feedback'
+import { hasPermission } from '@/utils/perm'
 import { ElMessageBox } from 'element-plus'
 import type { FormInstance, FormRules } from 'element-plus'
 import useUserStore from '@/stores/modules/user'
@@ -4747,13 +4763,31 @@ const shipForm = reactive({
 
 function openShip(row: { id: number; express_company?: unknown; tracking_number?: unknown; ship_mode?: unknown }) {
     shipRowId.value = row.id
-    shipForm.ship_mode = String(row.ship_mode || 'gancao') || 'gancao'
+    const tn = String(row.tracking_number ?? '').trim()
+    const sm = String(row.ship_mode ?? '').trim()
+    if (sm === 'direct' || sm === 'gancao') {
+        shipForm.ship_mode = sm
+    } else if (tn) {
+        // 已填单号时默认走药房直发（如快捷填单号后「确认发货」）
+        shipForm.ship_mode = 'direct'
+    } else {
+        shipForm.ship_mode = 'gancao'
+    }
     shipForm.express_company = String(row.express_company || 'auto') || 'auto'
     shipForm.tracking_number = String(row.tracking_number || '')
     shipVisible.value = true
 }
 
 async function submitShip() {
+    if (shipForm.ship_mode !== 'direct') {
+        if (!hasPermission(['tcm.prescriptionOrder/submitGancaoRecipel'])) {
+            feedback.msgError('暂无上传甘草药方权限，请改用「药房直发」并填写快递单号，或联系管理员开通权限')
+            return
+        }
+        shipVisible.value = false
+        await confirmSubmitGancaoRecipel({ id: shipRowId.value })
+        return
+    }
     if (!shipForm.tracking_number.trim()) {
         feedback.msgError('请先填写快递单号再确认发货')
         return
@@ -4762,7 +4796,7 @@ async function submitShip() {
     try {
         await prescriptionOrderShip({
             id: shipRowId.value,
-            ship_mode: shipForm.ship_mode === 'direct' ? 'direct' : 'gancao',
+            ship_mode: 'direct',
             express_company: shipForm.express_company || 'auto',
             tracking_number: shipForm.tracking_number.trim()
         })
diff --git a/server/app/adminapi/controller/tcm/PrescriptionController.php b/server/app/adminapi/controller/tcm/PrescriptionController.php
index b8846c8c..45785929 100644
--- a/server/app/adminapi/controller/tcm/PrescriptionController.php
+++ b/server/app/adminapi/controller/tcm/PrescriptionController.php
@@ -49,7 +49,7 @@ class PrescriptionController extends BaseAdminController
     }
 
     /**
-     * @notes 修正处方患者姓名手机号
+     * @notes 修正处方患者姓名手机性别
      */
     public function patchPatient()
     {
@@ -58,6 +58,7 @@ class PrescriptionController extends BaseAdminController
             (int) $params['id'],
             (string) $params['patient_name'],
             (string) $params['phone'],
+            (int) $params['gender'],
             (int) $this->adminId,
             $this->adminInfo
         );
diff --git a/server/app/adminapi/lists/tcm/PrescriptionOrderLists.php b/server/app/adminapi/lists/tcm/PrescriptionOrderLists.php
index 755bf596..ae38a118 100644
--- a/server/app/adminapi/lists/tcm/PrescriptionOrderLists.php
+++ b/server/app/adminapi/lists/tcm/PrescriptionOrderLists.php
@@ -495,7 +495,7 @@ class PrescriptionOrderLists extends BaseAdminDataLists implements ListsSearchIn
         if ($prescriptionIds !== []) {
             $prescriptions = \app\common\model\tcm\Prescription::whereIn('id', $prescriptionIds)
                 ->whereNull('delete_time')
-                ->field(['id', 'creator_id', 'doctor_name', 'phone'])
+                ->field(['id', 'creator_id', 'doctor_name', 'phone', 'assistant_id'])
                 ->select()
                 ->toArray();
             $doctorIds = [];
@@ -508,6 +508,7 @@ class PrescriptionOrderLists extends BaseAdminDataLists implements ListsSearchIn
                         'doctor_id' => $doctorId,
                         'doctor_name' => $doctorName,
                         'phone' => (string) ($rx['phone'] ?? ''),
+                        'assistant_id' => (int) ($rx['assistant_id'] ?? 0),
                     ];
                     if ($doctorId > 0) {
                         $doctorIds[] = $doctorId;
@@ -533,7 +534,20 @@ class PrescriptionOrderLists extends BaseAdminDataLists implements ListsSearchIn
         if ($diagIdsForAssist !== []) {
             $assistantByDiag = Diagnosis::whereIn('id', $diagIdsForAssist)->whereNull('delete_time')->column('assistant_id', 'id');
         }
-        $assistantIds = array_values(array_unique(array_filter(array_map('intval', array_values($assistantByDiag)))));
+        $assistantIds = [];
+        foreach (array_values($assistantByDiag) as $v) {
+            $vid = (int) $v;
+            if ($vid > 0) {
+                $assistantIds[] = $vid;
+            }
+        }
+        foreach ($prescriptionCreators as $pc) {
+            $aid = (int) ($pc['assistant_id'] ?? 0);
+            if ($aid > 0) {
+                $assistantIds[] = $aid;
+            }
+        }
+        $assistantIds = array_values(array_unique($assistantIds));
         $assistantNames = $assistantIds !== []
             ? \app\common\model\auth\Admin::whereIn('id', $assistantIds)->column('name', 'id')
             : [];
@@ -558,16 +572,18 @@ class PrescriptionOrderLists extends BaseAdminDataLists implements ListsSearchIn
             $creatorId = (int) ($item['creator_id'] ?? 0);
             $item['creator_name'] = $creatorId > 0 ? ($creatorNames[$creatorId] ?? '') : '';
 
-            // 添加医助（来自诊单 assistant_id）
+            // 医助：与处方列表一致优先关联处方 assistant_id，否则诊单 assistant_id（见 PrescriptionOrderLogic::resolveAssistantAdminIdForPrescriptionOrderRow）
             $diagIdForAssist = (int) ($item['diagnosis_id'] ?? 0);
-            $assistantIdForItem = (int) ($assistantByDiag[$diagIdForAssist] ?? 0);
+            $diagAst = (int) ($assistantByDiag[$diagIdForAssist] ?? 0);
+            $rxId = (int) ($item['prescription_id'] ?? 0);
+            $rxAst = $rxId > 0 ? (int) (($prescriptionCreators[$rxId] ?? [])['assistant_id'] ?? 0) : 0;
+            $assistantIdForItem = PrescriptionOrderLogic::resolveAssistantAdminIdForPrescriptionOrderRow($rxAst, $diagAst);
             $item['assistant_id'] = $assistantIdForItem;
             $item['assistant_name'] = $assistantIdForItem > 0
                 ? ($assistantNames[$assistantIdForItem] ?? '')
                 : '';
 
             // 添加开方人姓名、处方登记手机（与业务订单收货手机比对用）
-            $rxId = (int) ($item['prescription_id'] ?? 0);
             $item['doctor_name'] = $rxId > 0 ? ($prescriptionCreators[$rxId]['doctor_name'] ?? '') : '';
             $item['prescription_phone'] = $rxId > 0 ? ($prescriptionCreators[$rxId]['phone'] ?? '') : '';
         }
diff --git a/server/app/adminapi/logic/tcm/PrescriptionLogic.php b/server/app/adminapi/logic/tcm/PrescriptionLogic.php
index c89a4729..e4212c1d 100644
--- a/server/app/adminapi/logic/tcm/PrescriptionLogic.php
+++ b/server/app/adminapi/logic/tcm/PrescriptionLogic.php
@@ -437,9 +437,9 @@ class PrescriptionLogic
     }
 
     /**
-     * 仅修正处方笺展示用患者姓名与手机号（zyt_tcm_prescription），不改变审核状态与其它字段
+     * 仅修正处方笺展示用患者姓名、手机号与性别（zyt_tcm_prescription），不改变审核状态与其它字段
      */
-    public static function patchPatientContact(int $rxId, string $patientName, string $phone, int $adminId, array $adminInfo): bool
+    public static function patchPatientContact(int $rxId, string $patientName, string $phone, int $gender, int $adminId, array $adminInfo): bool
     {
         self::$error = '';
         $prescription = Prescription::find($rxId);
@@ -476,20 +476,38 @@ class PrescriptionLogic
 
             return false;
         }
+        if (!in_array($gender, [0, 1], true)) {
+            self::setError('性别无效');
+
+            return false;
+        }
 
         $oldName = trim((string) ($prescription->patient_name ?? ''));
         $oldPhone = trim((string) ($prescription->phone ?? ''));
+        $oldGender = (int) ($prescription->gender ?? 0);
 
-        if ($oldName === $patientName && $oldPhone === $phone) {
+        if ($oldName === $patientName && $oldPhone === $phone && $oldGender === $gender) {
             self::setError('信息未变更');
 
             return false;
         }
 
+        $genderText = static function (int $g): string {
+            if ($g === 1) {
+                return '男';
+            }
+            if ($g === 0) {
+                return '女';
+            }
+
+            return '未知';
+        };
+
         try {
             $prescription->save([
                 'patient_name' => $patientName,
                 'phone' => $phone,
+                'gender' => $gender,
             ]);
 
             $latestPo = PrescriptionOrder::where('prescription_id', $rxId)
@@ -500,13 +518,17 @@ class PrescriptionLogic
 
             $nameFrom = $oldName === '' ? '—' : $oldName;
             $phoneFrom = $oldPhone === '' ? '—' : $oldPhone;
+            $genderFrom = $genderText($oldGender);
+            $genderTo = $genderText($gender);
             $summary = sprintf(
-                '处方 #%d：患者姓名「%s」→「%s」，手机「%s」→「%s」',
+                '处方 #%d：患者姓名「%s」→「%s」，手机「%s」→「%s」，性别「%s」→「%s」',
                 $rxId,
                 $nameFrom,
                 $patientName,
                 $phoneFrom,
-                $phone
+                $phone,
+                $genderFrom,
+                $genderTo
             );
             PrescriptionOrderLogic::appendRxPatientPatchLog($logOrderId, $adminId, $adminInfo, $summary);
 
diff --git a/server/app/adminapi/logic/tcm/PrescriptionOrderLogic.php b/server/app/adminapi/logic/tcm/PrescriptionOrderLogic.php
index efca6310..63fbedf6 100644
--- a/server/app/adminapi/logic/tcm/PrescriptionOrderLogic.php
+++ b/server/app/adminapi/logic/tcm/PrescriptionOrderLogic.php
@@ -2486,6 +2486,25 @@ class PrescriptionOrderLogic
         return $m[$fs] ?? ('状态' . (string) $fs);
     }
 
+    /**
+     * 业务订单列表/导出：「诊单医助」admin id。
+     * 与 {@see PrescriptionLists} 一致优先 {@see Prescription::$assistant_id}（开方时从诊单快照到处方表）；
+     * 为 0 时再取诊单当前 {@see Diagnosis::$assistant_id}（兼容历史处方或未写入快照列的数据）。
+     */
+    public static function resolveAssistantAdminIdForPrescriptionOrderRow(
+        int $prescriptionAssistantId,
+        int $diagnosisAssistantId
+    ): int {
+        if ($prescriptionAssistantId > 0) {
+            return $prescriptionAssistantId;
+        }
+        if ($diagnosisAssistantId > 0) {
+            return $diagnosisAssistantId;
+        }
+
+        return 0;
+    }
+
     /**
      * 导出用：诊单医助在 admin_dept 中的部门路径（多部门「；」、路径内「 / 」）
      */
@@ -2656,7 +2675,7 @@ class PrescriptionOrderLogic
         $rxById = [];
         if ($rxIdList !== []) {
             $rxRows = Prescription::whereIn('id', $rxIdList)->whereNull('delete_time')
-                ->field(['id', 'prescription_type', 'need_decoction', 'dose_unit'])
+                ->field(['id', 'prescription_type', 'need_decoction', 'dose_unit', 'assistant_id'])
                 ->select()
                 ->toArray();
             foreach ($rxRows as $xr) {
@@ -2697,13 +2716,17 @@ class PrescriptionOrderLogic
 
             $diagId = (int) ($item['diagnosis_id'] ?? 0);
             $dg = $diagById[$diagId] ?? null;
+            $rxId = (int) ($item['prescription_id'] ?? 0);
+            $rx = $rxById[$rxId] ?? [];
             $item['export_patient_name'] = \is_array($dg) ? (string) ($dg['patient_name'] ?? '') : '';
             if (\is_array($dg)) {
                 $g = (int) ($dg['gender'] ?? 0);
                 $item['export_patient_gender'] = $g === 1 ? '男' : '女';
                 $item['export_patient_age'] = (string) ($dg['age'] ?? '');
                 $item['export_patient_phone'] = (string) ($dg['phone'] ?? '');
-                $astId = (int) ($dg['assistant_id'] ?? 0);
+                $rxAst = \is_array($rx) ? (int) ($rx['assistant_id'] ?? 0) : 0;
+                $diagAst = (int) ($dg['assistant_id'] ?? 0);
+                $astId = self::resolveAssistantAdminIdForPrescriptionOrderRow($rxAst, $diagAst);
                 if ($astId > 0) {
                     if (!isset($assistantDeptCache[$astId])) {
                         $assistantDeptCache[$astId] = self::formatAssistantDeptPathForExport($astId);
@@ -2719,8 +2742,6 @@ class PrescriptionOrderLogic
                 $item['export_assistant_dept'] = '';
             }
 
-            $rxId = (int) ($item['prescription_id'] ?? 0);
-            $rx = $rxById[$rxId] ?? [];
             $item['export_medication_form'] = self::formatMedicationFormForExport(\is_array($rx) ? $rx : []);
 
             $item['export_channel'] = (string) ($item['service_channel'] ?? '');
diff --git a/server/app/adminapi/validate/tcm/PrescriptionValidate.php b/server/app/adminapi/validate/tcm/PrescriptionValidate.php
index 8f0ef7eb..3ae41479 100644
--- a/server/app/adminapi/validate/tcm/PrescriptionValidate.php
+++ b/server/app/adminapi/validate/tcm/PrescriptionValidate.php
@@ -15,6 +15,7 @@ class PrescriptionValidate extends BaseValidate
         'dosage_bag_count' => 'integer|between:1,5',
         'patient_name' => 'require',
         'phone' => 'require|max:20',
+        'gender' => 'require|in:0,1',
         'clinical_diagnosis' => 'require',
         'herbs' => 'require|array',
         'action' => 'require|in:approve,reject',
@@ -27,6 +28,8 @@ class PrescriptionValidate extends BaseValidate
         'patient_name.require' => '患者姓名不能为空',
         'phone.require' => '手机号不能为空',
         'phone.max' => '手机号过长',
+        'gender.require' => '请选择性别',
+        'gender.in' => '性别无效',
         'clinical_diagnosis.require' => '临床诊断不能为空',
         'herbs.require' => '请添加中药',
     ];
@@ -68,7 +71,7 @@ class PrescriptionValidate extends BaseValidate
 
     public function scenePatchPatient()
     {
-        return $this->only(['id', 'patient_name', 'phone']);
+        return $this->only(['id', 'patient_name', 'phone', 'gender']);
     }
 
     public function sceneAudit()