fix(health): 四次审计修复 — 6 CRITICAL + 8 HIGH + 4 MEDIUM

CRITICAL:
- C-1: consultation sender_id 改为从 JWT ctx.user_id 注入，防伪造
- C-2: consultation session 更新改为 CAS 原子操作，防并发丢失
- C-3: 随访记录创建包裹在事务中，保证记录/任务/后续任务一致性
- C-4/C-5/C-6: 唯一索引改为 partial index WHERE deleted_at IS NULL

HIGH:
- H-1: manage_patient_tags 添加 tag_ids 租户归属校验
- H-2: assign_doctor 添加重复关联检查
- H-3: calendar_view 限制日期范围最多 90 天
- H-4: export_sessions 添加 10000 条上限
- H-5: patient_tag_relation/patient_doctor_relation 添加 version 字段
- H-6: create_schedule 添加医生存在性检查
- H-7: 预约取消排班释放错误改为日志记录
- H-8: follow_up_task.related_appointment_id 添加 FK 约束

MEDIUM:
- M-2: 修复 search LIKE 双重 % 包裹问题
- M-3: article_service 错误类型改为 ArticleNotFound
- M-4: patient.created 事件移除 PII（姓名）
- M-6: lab_report 添加 (tenant_id, report_type) 索引

crates/erp-server/migration/src/lib.rs

@@ -45,6 +45,7 @@ mod m20260423_000042_create_health_tables;
 mod m20260423_000043_create_wechat_users;
 mod m20260423_000044_create_articles;
 mod m20260424_000045_health_indexes;
+mod m20260424_000046_health_constraints_fix;
 
 pub struct Migrator;
 
@@ -97,6 +98,7 @@ impl MigratorTrait for Migrator {
             Box::new(m20260423_000043_create_wechat_users::Migration),
             Box::new(m20260423_000044_create_articles::Migration),
             Box::new(m20260424_000045_health_indexes::Migration),
+            Box::new(m20260424_000046_health_constraints_fix::Migration),
         ]
     }
 }

crates/erp-server/migration/src/m20260424_000046_health_constraints_fix.rs

@@ -0,0 +1,94 @@
+use sea_orm_migration::prelude::*;
+
+/// 迁移 000046: 修复唯一索引软删除兼容 + 关联表添加 version + 补充索引/FK
+#[derive(DeriveMigrationName)]
+pub struct Migration;
+
+#[async_trait::async_trait]
+impl MigrationTrait for Migration {
+    async fn up(&self, manager: &SchemaManager) -> Result<(), DbErr> {
+        let conn = manager.get_connection();
+
+        // C-4: patient.id_number 唯一索引 — 重建为 partial index WHERE deleted_at IS NULL
+        conn.execute_unprepared("DROP INDEX IF EXISTS idx_patient_tenant_id_number").await?;
+        conn.execute_unprepared(
+            "CREATE UNIQUE INDEX idx_patient_tenant_id_number ON patient (tenant_id, id_number) WHERE deleted_at IS NULL AND id_number IS NOT NULL"
+        ).await?;
+
+        // C-5: patient_tag.name 唯一索引 — 重建为 partial index WHERE deleted_at IS NULL
+        conn.execute_unprepared("DROP INDEX IF EXISTS idx_patient_tag_tenant_name_unique").await?;
+        conn.execute_unprepared(
+            "CREATE UNIQUE INDEX idx_patient_tag_tenant_name_unique ON patient_tag (tenant_id, name) WHERE deleted_at IS NULL"
+        ).await?;
+
+        // C-6: doctor_schedule 唯一索引 — 重建为 partial index，修正列选择为 (tenant_id, doctor_id, schedule_date, period_type)
+        conn.execute_unprepared("DROP INDEX IF EXISTS idx_doctor_schedule_unique_slot").await?;
+        conn.execute_unprepared(
+            "CREATE UNIQUE INDEX idx_doctor_schedule_unique_slot ON doctor_schedule (tenant_id, doctor_id, schedule_date, period_type) WHERE deleted_at IS NULL"
+        ).await?;
+
+        // H-5: patient_tag_relation 添加 version 列
+        conn.execute_unprepared(
+            "ALTER TABLE patient_tag_relation ADD COLUMN IF NOT EXISTS version integer NOT NULL DEFAULT 1"
+        ).await?;
+
+        // H-5: patient_doctor_relation 添加 version 列
+        conn.execute_unprepared(
+            "ALTER TABLE patient_doctor_relation ADD COLUMN IF NOT EXISTS version integer NOT NULL DEFAULT 1"
+        ).await?;
+
+        // H-8: follow_up_task.related_appointment_id 添加 FK 约束
+        conn.execute_unprepared(
+            "ALTER TABLE follow_up_task DROP CONSTRAINT IF EXISTS fk_follow_up_task_appointment"
+        ).await?;
+        conn.execute_unprepared(
+            "ALTER TABLE follow_up_task ADD CONSTRAINT fk_follow_up_task_appointment \
+             FOREIGN KEY (related_appointment_id) REFERENCES appointment(id) ON DELETE SET NULL"
+        ).await?;
+
+        // M-6: lab_report 添加 (tenant_id, report_type) 索引
+        conn.execute_unprepared(
+            "CREATE INDEX IF NOT EXISTS idx_lab_report_tenant_type ON lab_report (tenant_id, report_type)"
+        ).await?;
+
+        Ok(())
+    }
+
+    async fn down(&self, manager: &SchemaManager) -> Result<(), DbErr> {
+        let conn = manager.get_connection();
+
+        // 恢复原始索引（非 partial）
+        conn.execute_unprepared("DROP INDEX IF EXISTS idx_patient_tenant_id_number").await?;
+        conn.execute_unprepared(
+            "CREATE UNIQUE INDEX idx_patient_tenant_id_number ON patient (tenant_id, id_number)"
+        ).await?;
+
+        conn.execute_unprepared("DROP INDEX IF EXISTS idx_patient_tag_tenant_name_unique").await?;
+        conn.execute_unprepared(
+            "CREATE UNIQUE INDEX idx_patient_tag_tenant_name_unique ON patient_tag (tenant_id, name)"
+        ).await?;
+
+        conn.execute_unprepared("DROP INDEX IF EXISTS idx_doctor_schedule_unique_slot").await?;
+        conn.execute_unprepared(
+            "CREATE UNIQUE INDEX idx_doctor_schedule_unique_slot ON doctor_schedule (tenant_id, doctor_id, schedule_date, start_time)"
+        ).await?;
+
+        conn.execute_unprepared(
+            "ALTER TABLE patient_tag_relation DROP COLUMN IF EXISTS version"
+        ).await?;
+
+        conn.execute_unprepared(
+            "ALTER TABLE patient_doctor_relation DROP COLUMN IF EXISTS version"
+        ).await?;
+
+        conn.execute_unprepared(
+            "ALTER TABLE follow_up_task DROP CONSTRAINT IF EXISTS fk_follow_up_task_appointment"
+        ).await?;
+
+        conn.execute_unprepared(
+            "DROP INDEX IF EXISTS idx_lab_report_tenant_type"
+        ).await?;
+
+        Ok(())
+    }
+}