diff --git a/admin/src/api/tcm.ts b/admin/src/api/tcm.ts
index 87725a67..55a698a0 100644
--- a/admin/src/api/tcm.ts
+++ b/admin/src/api/tcm.ts
@@ -221,7 +221,7 @@ export function generateOrderQrcode(params: any) {
 // ========== IM / 企业微信聊天记录 ==========
 
 /** 腾讯云 IM 单聊漫游消息（诊单维度：患者 patient_* 与医生 doctor_*） */
-export function getImChatMessages(params: { diagnosis_id: number }) {
+export function getImChatMessages(params: { diagnosis_id: number; only_archived?: 0 | 1 }) {
     return request.get({ url: '/tcm.diagnosis/getImChatMessages', params })
 }
 
diff --git a/admin/src/views/consumer/prescription/index.vue b/admin/src/views/consumer/prescription/index.vue
index 0a831575..5c1cdaec 100644
--- a/admin/src/views/consumer/prescription/index.vue
+++ b/admin/src/views/consumer/prescription/index.vue
@@ -1448,6 +1448,7 @@ const createOrderRules: FormRules = {
     patient_id: [{ required: true, message: '请选择诊单患者', trigger: 'change' }],
     recipient_name: [{ required: true, message: '请输入收货人', trigger: 'blur' }],
     recipient_phone: [{ required: true, message: '请输入收货手机', trigger: 'blur' }],
+    region: [{ required: true, message: '请选择省/市/区', trigger: 'change', type: 'array' }],
     shipping_address: [{ required: true, message: '请输入收货地址', trigger: 'blur' }],
     fee_type: [{ required: true, message: '请选择费用类别', trigger: 'change' }],
     amount: [
diff --git a/admin/src/views/consumer/prescription/order_list.vue b/admin/src/views/consumer/prescription/order_list.vue
index 9b945386..4eea0cae 100644
--- a/admin/src/views/consumer/prescription/order_list.vue
+++ b/admin/src/views/consumer/prescription/order_list.vue
@@ -2243,6 +2243,7 @@ async function loadEditPaidOrders(diagnosisId: number, prescriptionOrderId?: num
 const editRules: FormRules = {
     recipient_name: [{ required: true, message: '请输入收货人', trigger: 'blur' }],
     recipient_phone: [{ required: true, message: '请输入手机', trigger: 'blur' }],
+    region: [{ required: true, message: '请选择省/市/区', trigger: 'change', type: 'array' }],
     shipping_address: [{ required: true, message: '请输入地址', trigger: 'blur' }],
     fee_type: [{ required: true, message: '请选择费用类别', trigger: 'change' }],
     amount: [
diff --git a/admin/src/views/tcm/diagnosis/components/ImChatRecordPanel.vue b/admin/src/views/tcm/diagnosis/components/ImChatRecordPanel.vue
index 29c72975..27289296 100644
--- a/admin/src/views/tcm/diagnosis/components/ImChatRecordPanel.vue
+++ b/admin/src/views/tcm/diagnosis/components/ImChatRecordPanel.vue
@@ -9,9 +9,9 @@
         </el-alert>
 
         <div class="toolbar mb-3">
-            <el-button type="primary" link :loading="loading" @click="load">
+            <el-button type="primary" link :loading="loading" @click="refreshLive">
                 <el-icon class="mr-1"><Refresh /></el-icon>
-                刷新
+                刷新（同步云端最新）
             </el-button>
         </div>
 
@@ -19,44 +19,42 @@
             <template v-if="!loading && rows.length">
                 <div class="chat-list">
                     <div
-                        v-for="row in rows"
-                        :key="row.msg_id"
+                        v-for="item in rows"
+                        :key="item.raw.msg_id"
                         class="chat-row"
-                        :class="row.is_from_doctor ? 'from-doctor' : 'from-patient'"
+                        :class="item.raw.is_from_doctor ? 'from-doctor' : 'from-patient'"
                     >
                         <div class="meta">
-                            <span class="name">{{ senderLabel(row) }}</span>
-                            <span class="time">{{ formatTime(row.time) }}</span>
-                            <el-tag v-if="typeLabel(row)" size="small" type="info" class="ml-2">
-                                {{ typeLabel(row) }}
+                            <span class="name">{{ senderLabel(item.raw) }}</span>
+                            <span class="time">{{ formatTime(item.raw.time) }}</span>
+                            <el-tag v-if="item.tag" size="small" type="info" class="ml-2">
+                                {{ item.tag }}
                             </el-tag>
                         </div>
                         <div class="bubble">
-                            <template v-if="row.msg_type === 'image' && row.image_url">
+                            <template v-if="item.raw.msg_type === 'image' && item.raw.image_url">
                                 <el-image
-                                    :src="row.image_url"
-                                    :preview-src-list="[row.image_url]"
+                                    :src="item.raw.image_url"
+                                    :preview-src-list="[item.raw.image_url]"
                                     fit="contain"
                                     class="chat-img"
                                 />
                             </template>
-                            <template v-else-if="(row.msg_type === 'file' || row.msg_type === 'sound' || row.msg_type === 'video') && row.file_url">
-                                <el-link :href="row.file_url" target="_blank" type="primary">
-                                    {{ row.file_name || '打开文件' }}
+                            <template v-else-if="(item.raw.msg_type === 'file' || item.raw.msg_type === 'sound' || item.raw.msg_type === 'video') && item.raw.file_url">
+                                <el-link :href="item.raw.file_url" target="_blank" type="primary">
+                                    {{ item.raw.file_name || '打开文件' }}
                                 </el-link>
                             </template>
                             <template v-else>
-                                <template v-for="fr in [parseImFriendly(row)]" :key="row.msg_id + '-body'">
-                                    <div v-if="fr" class="friendly-text">
-                                        <div class="friendly-main">{{ fr.main }}</div>
-                                        <div v-if="fr.sub" class="friendly-sub">{{ fr.sub }}</div>
-                                    </div>
-                                    <div v-else-if="row.msg_type === 'text' && row.text" class="text-content">
-                                        {{ row.text }}
-                                    </div>
-                                    <div v-else-if="row.text" class="text-content">{{ row.text }}</div>
-                                    <span v-else class="muted">（无法展示该消息类型）</span>
-                                </template>
+                                <div v-if="item.friendly" class="friendly-text">
+                                    <div class="friendly-main">{{ item.friendly.main }}</div>
+                                    <div v-if="item.friendly.sub" class="friendly-sub">{{ item.friendly.sub }}</div>
+                                </div>
+                                <div v-else-if="item.raw.msg_type === 'text' && item.raw.text" class="text-content">
+                                    {{ item.raw.text }}
+                                </div>
+                                <div v-else-if="item.raw.text" class="text-content">{{ item.raw.text }}</div>
+                                <span v-else class="muted">（无法展示该消息类型）</span>
                             </template>
                         </div>
                     </div>
@@ -80,12 +78,43 @@ const props = defineProps<{
 }>()
 
 const loading = ref(false)
-const rows = shallowRef<any[]>([])
+const rawRows = shallowRef<any[]>([])
 const patientImId = ref('')
 const patientName = ref('')
 
 const patientImHint = computed(() => patientImId.value || 'patient_*')
 
+interface EnrichedRow {
+    raw: any
+    friendly: FriendlyParse | null
+    tag: string
+}
+
+const MSG_TYPE_LABELS: Record<string, string> = {
+    text: '',
+    image: '图片',
+    file: '文件',
+    sound: '语音',
+    video: '视频',
+    location: '位置',
+    custom: '自定义',
+    face: '表情',
+    other: ''
+}
+
+const rows = computed<EnrichedRow[]>(() =>
+    rawRows.value.map((row) => {
+        const fr = parseImFriendly(row)
+        let tag = ''
+        if (fr?.tag) {
+            tag = fr.tag
+        } else {
+            tag = MSG_TYPE_LABELS[row.msg_type] || (row.msg_type !== 'other' ? row.msg_type : '')
+        }
+        return { raw: row, friendly: fr, tag }
+    })
+)
+
 function formatTime(ts: number | undefined) {
     if (ts == null || !ts) return '—'
     const sec = ts > 1e12 ? Math.floor(ts / 1000) : ts
@@ -103,23 +132,6 @@ function parseImFriendly(row: any): FriendlyParse | null {
     return null
 }
 
-function typeLabel(row: any) {
-    const fr = parseImFriendly(row)
-    if (fr?.tag) return fr.tag
-    const m: Record<string, string> = {
-        text: '',
-        image: '图片',
-        file: '文件',
-        sound: '语音',
-        video: '视频',
-        location: '位置',
-        custom: '自定义',
-        face: '表情',
-        other: ''
-    }
-    return m[row.msg_type] || (row.msg_type !== 'other' ? row.msg_type : '')
-}
-
 function senderLabel(row: any) {
     if (row.is_from_doctor) {
         return row.from_staff_name ? `医生（${row.from_staff_name}）` : '医生/员工'
@@ -127,35 +139,42 @@ function senderLabel(row: any) {
     return patientName.value ? `患者（${patientName.value}）` : '患者'
 }
 
-async function load() {
+async function load(onlyArchived = false) {
     if (!props.diagnosisId) return
     loading.value = true
     try {
-        const res = (await getImChatMessages({ diagnosis_id: props.diagnosisId })) as {
+        const res = (await getImChatMessages({
+            diagnosis_id: props.diagnosisId,
+            only_archived: onlyArchived ? 1 : 0
+        })) as {
             lists?: any[]
             patient_im_id?: string
             patient_name?: string
         }
-        rows.value = res?.lists || []
+        rawRows.value = res?.lists || []
         patientImId.value = res?.patient_im_id || ''
         patientName.value = res?.patient_name || ''
     } catch (e) {
         console.error(e)
-        rows.value = []
+        rawRows.value = []
     } finally {
         loading.value = false
     }
 }
 
+function refreshLive() {
+    load(false)
+}
+
 watch(
     () => props.diagnosisId,
     () => {
-        load()
+        load(true)
     },
     { immediate: true }
 )
 
-defineExpose({ refresh: load })
+defineExpose({ refresh: refreshLive })
 </script>
 
 <style scoped lang="scss">
diff --git a/server/app/adminapi/controller/tcm/DiagnosisController.php b/server/app/adminapi/controller/tcm/DiagnosisController.php
index 62094f58..bec844a4 100644
--- a/server/app/adminapi/controller/tcm/DiagnosisController.php
+++ b/server/app/adminapi/controller/tcm/DiagnosisController.php
@@ -303,12 +303,13 @@ class DiagnosisController extends BaseAdminController
     {
         // 增加执行时间限制到 120 秒
         set_time_limit(120);
-        
+
         $diagnosisId = (int)$this->request->get('diagnosis_id', 0);
         if ($diagnosisId <= 0) {
             return $this->fail('诊单ID不能为空');
         }
-        $result = DiagnosisLogic::getImChatMessagesForDiagnosis($diagnosisId);
+        $onlyArchived = (int)$this->request->get('only_archived', 0) === 1;
+        $result = DiagnosisLogic::getImChatMessagesForDiagnosis($diagnosisId, $onlyArchived);
         if ($result === false) {
             return $this->fail(DiagnosisLogic::getError());
         }
diff --git a/server/app/adminapi/logic/tcm/DiagnosisLogic.php b/server/app/adminapi/logic/tcm/DiagnosisLogic.php
index a03b7238..a3a2ce33 100644
--- a/server/app/adminapi/logic/tcm/DiagnosisLogic.php
+++ b/server/app/adminapi/logic/tcm/DiagnosisLogic.php
@@ -736,8 +736,11 @@ class DiagnosisLogic extends BaseLogic
 
     /**
      * @notes 拉取与本诊单相关的 IM 单聊记录：本地归档 + 腾讯云漫游合并（归档突破云端约 7 天限制）
+     *
+     * @param int $diagnosisId
+     * @param bool $onlyArchived 只读取本地归档，不请求腾讯云（用于首次打开快速展示）
      */
-    public static function getImChatMessagesForDiagnosis(int $diagnosisId)
+    public static function getImChatMessagesForDiagnosis(int $diagnosisId, bool $onlyArchived = false)
     {
         try {
             $diag = Diagnosis::where('id', $diagnosisId)->where('delete_time', null)->find();
@@ -753,6 +756,17 @@ class DiagnosisLogic extends BaseLogic
             $patientImId = 'patient_' . $patientId;
             $archived = self::loadArchivedImChatRows($diagnosisId);
 
+            if ($onlyArchived) {
+                $lists = self::enrichImMessagesWithStaffNames($archived);
+                return [
+                    'lists' => $lists,
+                    'patient_im_id' => $patientImId,
+                    'patient_name' => $diag['patient_name'] ?? '',
+                    'doctor_accounts_queried' => [],
+                    'only_archived' => true,
+                ];
+            }
+
             $config = self::getTrtcConfig();
             if (!$config) {
                 if (empty($archived)) {
@@ -780,10 +794,19 @@ class DiagnosisLogic extends BaseLogic
                 return false;
             }
 
-            $live = self::pullLiveImChatMessagesForDiagnosis($diag);
+            $live = self::pullLiveImChatMessagesForDiagnosis($diag, $doctorAccounts);
             $merged = self::mergeImMessagesByMsgId($archived, $live);
             $merged = self::enrichImMessagesWithStaffNames($merged);
 
+            // 首次云端拉取后异步落库，下一次即可直接读归档，无需再全量扫描医生账号
+            if (!empty($live)) {
+                try {
+                    self::persistImChatArchiveRows($diagnosisId, $patientId, $live);
+                } catch (\Throwable $e) {
+                    \think\facade\Log::warning('archive im chat on-the-fly failed: ' . $e->getMessage());
+                }
+            }
+
             return [
                 'lists' => $merged,
                 'patient_im_id' => $patientImId,
@@ -814,7 +837,13 @@ class DiagnosisLogic extends BaseLogic
                 $out['error'] = '诊单不存在';
                 return $out;
             }
-            $live = self::pullLiveImChatMessagesForDiagnosis($diag);
+            $accounts = self::collectAllDoctorImPeerAccounts();
+            $assistantId = isset($diag['assistant_id']) ? (int)$diag['assistant_id'] : 0;
+            if ($assistantId > 0) {
+                $accounts[] = 'doctor_' . $assistantId;
+                $accounts = array_values(array_unique($accounts));
+            }
+            $live = self::pullLiveImChatMessagesForDiagnosis($diag, $accounts);
             if (empty($live)) {
                 $out['skipped_live_empty'] = true;
                 return $out;
@@ -926,19 +955,16 @@ class DiagnosisLogic extends BaseLogic
      * @param Diagnosis|array<string, mixed> $diag
      * @return array<int, array<string, mixed>>
      */
-    private static function pullLiveImChatMessagesForDiagnosis($diag): array
+    /**
+     * @param array<int, string> $doctorAccounts 已筛选的医生 IM 账号列表
+     */
+    private static function pullLiveImChatMessagesForDiagnosis($diag, array $doctorAccounts = []): array
     {
         $patientId = (int)$diag['patient_id'];
         if ($patientId <= 0) {
             return [];
         }
         $patientImId = 'patient_' . $patientId;
-        $doctorAccounts = self::collectAllDoctorImPeerAccounts();
-        $assistantId = isset($diag['assistant_id']) ? (int)$diag['assistant_id'] : 0;
-        if ($assistantId > 0) {
-            $doctorAccounts[] = 'doctor_' . $assistantId;
-        }
-        $doctorAccounts = array_values(array_unique($doctorAccounts));
         if (empty($doctorAccounts)) {
             return [];
         }