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 eb2b96a0..9fab3292 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
@@ -100,6 +100,12 @@ public class AskPrimaryServiceImpl implements AskPrimaryService {
     @Override
     @Transactional(rollbackFor = Exception.class)
     public void savePrimary(SaveDiagnosisPrimaryReqVO reqVO) {
+        // 新增初步诊断之前,校验是否已经存在相同的初步诊断,如果有了,则不允许重复添加
+        Integer count = diagnosisPrimaryService.lambdaQuery().eq(DiagnosisPrimary::getProcessId, reqVO.getProcessId())
+                .eq(DiagnosisPrimary::getPrimaryDiagnosisId, reqVO.getPrimaryDiagnosisId()).count();
+        if (0 < count) {
+            throw new BusinessException("已经存在该疾病的初步诊断");
+        }
         DiagnosisPrimary diagnosisPrimary = BeanUtil.toBean(reqVO, DiagnosisPrimary.class);
         diagnosisPrimary.setExcludeFlag(null);
         diagnosisPrimary.setCreateUserId(UserUtil.getUser().getId());