diff --git a/virtual-patient-web/src/main/java/com/supervision/service/impl/AskPrimaryServiceImpl.java b/virtual-patient-web/src/main/java/com/supervision/service/impl/AskPrimaryServiceImpl.java
index 9fab3292..76e1df51 100644
--- a/virtual-patient-web/src/main/java/com/supervision/service/impl/AskPrimaryServiceImpl.java
+++ b/virtual-patient-web/src/main/java/com/supervision/service/impl/AskPrimaryServiceImpl.java
@@ -2,6 +2,8 @@ package com.supervision.service.impl;
 
 import cn.hutool.core.bean.BeanUtil;
 import cn.hutool.core.collection.CollUtil;
+import cn.hutool.core.collection.CollectionUtil;
+import cn.hutool.core.lang.Assert;
 import cn.hutool.core.util.StrUtil;
 import com.supervision.exception.BusinessException;
 import com.supervision.model.*;
@@ -109,6 +111,13 @@ public class AskPrimaryServiceImpl implements AskPrimaryService {
         DiagnosisPrimary diagnosisPrimary = BeanUtil.toBean(reqVO, DiagnosisPrimary.class);
         diagnosisPrimary.setExcludeFlag(null);
         diagnosisPrimary.setCreateUserId(UserUtil.getUser().getId());
+
+        String primaryDiagnosisId = diagnosisPrimary.getPrimaryDiagnosisId();
+        Assert.notEmpty(primaryDiagnosisId,"疾病不能为空");
+        List<DiagnosisPrimary> dbList = diagnosisPrimaryService.lambdaQuery().eq(DiagnosisPrimary::getPrimaryDiagnosisId, primaryDiagnosisId)
+                .eq(DiagnosisPrimary::getProcessId, diagnosisPrimary.getProcessId()).list();
+        Assert.isTrue(CollectionUtil.isEmpty(dbList),"初步诊断已存在");
+
         diagnosisPrimaryService.save(diagnosisPrimary);
         // 然后开始保存初步诊断关键的诊断