diff --git a/admin/src/views/tcm/diagnosis/index.vue b/admin/src/views/tcm/diagnosis/index.vue
index d5445ec3..efb84732 100644
--- a/admin/src/views/tcm/diagnosis/index.vue
+++ b/admin/src/views/tcm/diagnosis/index.vue
@@ -15,7 +15,7 @@
                     </span>
                 </div>
                 <div class="search-row">
-                    <el-input v-model="formData.patient_name" placeholder="患者姓名" clearable class="search-input" @keyup.enter="doSearch" />
+                    <el-input v-model="formData.keyword" placeholder="患者姓名 / 手机号" clearable class="search-input" @keyup.enter="doSearch" />
                     <el-button type="primary" @click="doSearch">查询</el-button>
                 </div>
             </div>
@@ -111,7 +111,7 @@
                         <div >{{ row.gender_desc || '-' }} · {{ row.age ?? '-' }}岁</div>
                     </template>
                 </el-table-column>
-                <el-table-column label="挂号" min-width="180">
+                <el-table-column label="挂号" min-width="150">
                     <template #default="{ row }">
                         <div
                             class="appointment-cell"
@@ -146,7 +146,7 @@
                         <span v-else class="status-unconfirmed">未确认</span>
                     </template>
                 </el-table-column>
-                <el-table-column label="复诊" min-width="150">
+                <el-table-column label="复诊" min-width="120">
                     <template #default="{ row }">
                         <div v-if="row.has_prescription" class="followup-cell">
                             <div class="followup-time">{{ row.followup_time_text || '—' }}</div>
@@ -164,7 +164,7 @@
                         <span v-else class="followup-none">无</span>
                     </template>
                 </el-table-column>
-                <el-table-column label="助理" width="72" show-overflow-tooltip>
+                <el-table-column label="助理" width="100" show-overflow-tooltip>
                     <template #default="{ row }">
                         <span class="assistant-cell">{{ getAssistantName(row.assistant_id || row.assistant) }}</span>
                     </template>
@@ -567,7 +567,7 @@ const maskIdCard = (idCard: string) => {
 }
 
 const formData = reactive({
-    patient_name: '',
+    keyword: '',
     diagnosis_type: '',
     syndrome_type: '',
     assistant_id: '',
@@ -761,7 +761,7 @@ const refreshListAfterPopupSave = () => getLists({ silent: true })
 // 重置
 const handleReset = () => {
     activeTab.value = 'all'
-    formData.patient_name = ''
+    formData.keyword = ''
     formData.diagnosis_type = ''
     formData.syndrome_type = ''
     formData.assistant_id = ''
diff --git a/server/app/adminapi/lists/tcm/DiagnosisLists.php b/server/app/adminapi/lists/tcm/DiagnosisLists.php
index 459bfd19..a372649a 100644
--- a/server/app/adminapi/lists/tcm/DiagnosisLists.php
+++ b/server/app/adminapi/lists/tcm/DiagnosisLists.php
@@ -65,6 +65,15 @@ class DiagnosisLists extends BaseAdminDataLists implements ListsSearchInterface
             $query->where('assistant_id', $this->adminId);
         }
 
+        // 关键字搜索：支持患者姓名或手机号（模糊匹配）
+        if (isset($this->params['keyword']) && trim((string) $this->params['keyword']) !== '') {
+            $keyword = trim((string) $this->params['keyword']);
+            $query->where(function ($q) use ($keyword) {
+                $q->whereLike('patient_name', '%' . $keyword . '%')
+                    ->whereOr('phone', 'like', '%' . $keyword . '%');
+            });
+        }
+
         // 是否确认诊单：1=已确认 0=未确认
         if (isset($this->params['diagnosis_confirmed']) && $this->params['diagnosis_confirmed'] !== '') {
             $confirmed = (int)$this->params['diagnosis_confirmed'];
@@ -409,6 +418,15 @@ class DiagnosisLists extends BaseAdminDataLists implements ListsSearchInterface
             $query->where('assistant_id', $this->adminId);
         }
 
+        // 关键字搜索：支持患者姓名或手机号（模糊匹配）
+        if (isset($this->params['keyword']) && trim((string) $this->params['keyword']) !== '') {
+            $keyword = trim((string) $this->params['keyword']);
+            $query->where(function ($q) use ($keyword) {
+                $q->whereLike('patient_name', '%' . $keyword . '%')
+                    ->whereOr('phone', 'like', '%' . $keyword . '%');
+            });
+        }
+
         // 是否确认诊单
         if (isset($this->params['diagnosis_confirmed']) && $this->params['diagnosis_confirmed'] !== '') {
             $confirmed = (int)$this->params['diagnosis_confirmed'];