diff --git a/admin/src/views/tcm/diagnosis/components/AssignLogPanel.vue b/admin/src/views/tcm/diagnosis/components/AssignLogPanel.vue
index 46a56711..892b96a2 100644
--- a/admin/src/views/tcm/diagnosis/components/AssignLogPanel.vue
+++ b/admin/src/views/tcm/diagnosis/components/AssignLogPanel.vue
@@ -12,6 +12,12 @@
                     {{ assistantLogCellText(row, 'to') }}
                 </template>
             </el-table-column>
+            <el-table-column label="继承" width="72" align="center">
+                <template #default="{ row }">
+                    <el-tag v-if="Number(row.is_inherit) === 1" type="success" size="small">是</el-tag>
+                    <span v-else class="text-gray-400">否</span>
+                </template>
+            </el-table-column>
             <el-table-column label="快照·业务单创建人" min-width="130" show-overflow-tooltip>
                 <template #default="{ row }">
                     {{ relatedPoCreatorCell(row) }}
diff --git a/admin/src/views/tcm/diagnosis/index.vue b/admin/src/views/tcm/diagnosis/index.vue
index d771f723..498269c3 100644
--- a/admin/src/views/tcm/diagnosis/index.vue
+++ b/admin/src/views/tcm/diagnosis/index.vue
@@ -456,6 +456,10 @@
                         />
                     </el-select>
                 </el-form-item>
+                <el-form-item label="继承">
+                    <el-checkbox v-model="assignForm.is_inherit">继承</el-checkbox>
+                    <span class="text-gray-400 text-xs ml-2">勾选后写入指派记录</span>
+                </el-form-item>
                 <el-form-item v-if="assignMode === 'batch'" label="已选择">
                     <div class="text-gray-500">{{ batchAssignIds.length }} 条诊单记录</div>
                 </el-form-item>
@@ -1340,12 +1344,14 @@ const assignLoading = ref(false)
 const assignMode = ref<'batch' | 'single'>('batch')
 const currentRow = ref<any>(null)
 const assignForm = ref({
-    assistant_id: null as number | null
+    assistant_id: null as number | null,
+    is_inherit: false
 })
 
 function resetAssignDialog() {
     batchAssignIds.value = []
     assignForm.value.assistant_id = null
+    assignForm.value.is_inherit = false
 }
 
 const handleSelectionChange = (selection: any[]) => {
@@ -1372,6 +1378,7 @@ const handleSingleAssign = (row: any) => {
     batchAssignIds.value = []
     // 确保类型一致，转换为数字
     assignForm.value.assistant_id = Number(row.assistant_id) > 0 ? Number(row.assistant_id) : null
+    assignForm.value.is_inherit = false
     assignDialogVisible.value = true
 }
 
@@ -1384,6 +1391,7 @@ const handleBatchAssign = () => {
     assignMode.value = 'batch'
     currentRow.value = null
     assignForm.value.assistant_id = null
+    assignForm.value.is_inherit = false
     batchAssignIds.value = [...selectedIds.value]
     assignDialogVisible.value = true
 }
@@ -1400,7 +1408,8 @@ const handleConfirmAssign = async () => {
             // 单独指派
             await tcmDiagnosisAssign({ 
                 id: currentRow.value.id, 
-                assistant_id: assignForm.value.assistant_id 
+                assistant_id: assignForm.value.assistant_id,
+                is_inherit: assignForm.value.is_inherit ? 1 : 0
             })
         } else {
             // 批量指派：使用打开弹窗时的 id 快照（避免弹窗内操作导致表格勾选被清空后提交为空）
@@ -1413,6 +1422,7 @@ const handleConfirmAssign = async () => {
                 await tcmDiagnosisAssign({
                     id,
                     assistant_id: assignForm.value.assistant_id!,
+                    is_inherit: assignForm.value.is_inherit ? 1 : 0
                 })
             }
             selectedIds.value = []
diff --git a/admin/src/views/tcm/diagnosis/index_h5.vue b/admin/src/views/tcm/diagnosis/index_h5.vue
index 0324f428..7cc9dacf 100644
--- a/admin/src/views/tcm/diagnosis/index_h5.vue
+++ b/admin/src/views/tcm/diagnosis/index_h5.vue
@@ -364,6 +364,10 @@
                         />
                     </el-select>
                 </el-form-item>
+                <el-form-item label="继承">
+                    <el-checkbox v-model="assignForm.is_inherit">继承</el-checkbox>
+                    <span class="text-gray-400 text-xs ml-2">勾选后写入指派记录</span>
+                </el-form-item>
                 <el-form-item label="诊单信息">
                     <div class="dh5-form-tip">
                         <div>患者：{{ currentRow?.patient_name }}</div>
@@ -1080,10 +1084,11 @@ const runAction = (cmd: string) => {
 const assignDialogVisible = ref(false)
 const assignLoading = ref(false)
 const currentRow = ref<any>(null)
-const assignForm = ref({ assistant_id: null as number | null })
+const assignForm = ref({ assistant_id: null as number | null, is_inherit: false })
 const handleSingleAssign = (row: any) => {
     currentRow.value = row
     assignForm.value.assistant_id = row.assistant_id ? Number(row.assistant_id) : null
+    assignForm.value.is_inherit = false
     assignDialogVisible.value = true
 }
 const handleConfirmAssign = async () => {
@@ -1092,7 +1097,8 @@ const handleConfirmAssign = async () => {
     try {
         await tcmDiagnosisAssign({
             id: currentRow.value.id,
-            assistant_id: assignForm.value.assistant_id
+            assistant_id: assignForm.value.assistant_id,
+            is_inherit: assignForm.value.is_inherit ? 1 : 0
         })
         assignDialogVisible.value = false
         getLists()
diff --git a/admin/src/views/tcm/follow/index.vue b/admin/src/views/tcm/follow/index.vue
index 9a9ae541..633d1c7e 100644
--- a/admin/src/views/tcm/follow/index.vue
+++ b/admin/src/views/tcm/follow/index.vue
@@ -326,6 +326,10 @@
                         />
                     </el-select>
                 </el-form-item>
+                <el-form-item label="继承">
+                    <el-checkbox v-model="assignForm.is_inherit">继承</el-checkbox>
+                    <span class="text-gray-400 text-xs ml-2">勾选后写入指派记录</span>
+                </el-form-item>
                 <el-form-item v-if="assignMode === 'batch'" label="已选择">
                     <div class="text-gray-500">{{ selectedIds.length }} 条诊单记录</div>
                 </el-form-item>
@@ -1078,7 +1082,8 @@ const assignLoading = ref(false)
 const assignMode = ref<'batch' | 'single'>('batch')
 const currentRow = ref<any>(null)
 const assignForm = ref({
-    assistant_id: null as number | null
+    assistant_id: null as number | null,
+    is_inherit: false
 })
 
 const handleSelectionChange = (selection: any[]) => {
@@ -1091,6 +1096,7 @@ const handleSingleAssign = (row: any) => {
     currentRow.value = row
     // 确保类型一致，转换为数字
     assignForm.value.assistant_id = Number(row.assistant_id) > 0 ? Number(row.assistant_id) : null
+    assignForm.value.is_inherit = false
     assignDialogVisible.value = true
 }
 
@@ -1103,6 +1109,7 @@ const handleBatchAssign = () => {
     assignMode.value = 'batch'
     currentRow.value = null
     assignForm.value.assistant_id = null
+    assignForm.value.is_inherit = false
     assignDialogVisible.value = true
 }
 
@@ -1118,14 +1125,16 @@ const handleConfirmAssign = async () => {
             // 单独指派
             await tcmDiagnosisAssign({ 
                 id: currentRow.value.id, 
-                assistant_id: assignForm.value.assistant_id 
+                assistant_id: assignForm.value.assistant_id,
+                is_inherit: assignForm.value.is_inherit ? 1 : 0
             })
         } else {
             // 批量指派
             const promises = selectedIds.value.map(id => 
                 tcmDiagnosisAssign({ 
                     id, 
-                    assistant_id: assignForm.value.assistant_id 
+                    assistant_id: assignForm.value.assistant_id,
+                    is_inherit: assignForm.value.is_inherit ? 1 : 0
                 })
             )
             await Promise.all(promises)
diff --git a/server/app/adminapi/logic/tcm/DiagnosisLogic.php b/server/app/adminapi/logic/tcm/DiagnosisLogic.php
index 8f643b71..e1a7b23d 100755
--- a/server/app/adminapi/logic/tcm/DiagnosisLogic.php
+++ b/server/app/adminapi/logic/tcm/DiagnosisLogic.php
@@ -563,6 +563,7 @@ class DiagnosisLogic extends BaseLogic
         try {
             $id = (int) ($params['id'] ?? 0);
             $toAssistantId = (int) ($params['assistant_id'] ?? 0);
+            $isInherit = (int) ($params['is_inherit'] ?? 0) === 1 && $toAssistantId > 0 ? 1 : 0;
             if ($id <= 0) {
                 self::setError('诊单不存在');
 
@@ -623,6 +624,7 @@ class DiagnosisLogic extends BaseLogic
                     'ip'                      => (string) ($req->ip() ?? ''),
                     'related_po_creator_id'   => $relatedPoCreatorId,
                     'related_po_create_time'  => $relatedPoCreateTime,
+                    'is_inherit'              => $isInherit,
                     'create_time'             => $now,
                 ]);
             } catch (\Throwable $e) {
@@ -696,6 +698,9 @@ class DiagnosisLogic extends BaseLogic
             $r['related_po_create_time_text'] = $rpct > 0 ? date('Y-m-d H:i:s', $rpct) : '';
             $r['related_po_is_cleared_assistant_creator'] =
                 ($rcpId > 0 && $fromId > 0 && $rcpId === $fromId) ? 1 : 0;
+            $inherit = (int) ($r['is_inherit'] ?? 0);
+            $r['is_inherit'] = $inherit;
+            $r['is_inherit_text'] = $inherit === 1 ? '是' : '否';
         }
         unset($r);
 
diff --git a/server/sql/1.9.20260601/add_diagnosis_assign_log_is_inherit.sql b/server/sql/1.9.20260601/add_diagnosis_assign_log_is_inherit.sql
new file mode 100644
index 00000000..f5570f88
--- /dev/null
+++ b/server/sql/1.9.20260601/add_diagnosis_assign_log_is_inherit.sql
@@ -0,0 +1,5 @@
+-- 诊单指派日志：是否标记为「继承」指派（后台人工指派时可勾选）
+-- 首次执行即可；若列已存在重复执行会报错，可忽略
+
+ALTER TABLE `zyt_tcm_diagnosis_assign_log`
+ADD COLUMN `is_inherit` tinyint unsigned NOT NULL DEFAULT 0 COMMENT '是否继承指派：1=是，0=否' AFTER `related_po_create_time`;