diff --git a/apps/miniprogram/src/hooks/usePageData.ts b/apps/miniprogram/src/hooks/usePageData.ts
index 34812f4..85538d4 100644
--- a/apps/miniprogram/src/hooks/usePageData.ts
+++ b/apps/miniprogram/src/hooks/usePageData.ts
@@ -1,5 +1,5 @@
-import { useRef, useState, useCallback } from 'react';
-import Taro, { useDidShow, usePullDownRefresh } from '@tarojs/taro';
+import { useRef, useState, useCallback, useEffect } from 'react';
+import Taro, { useDidShow, useDidHide, usePullDownRefresh } from '@tarojs/taro';
 
 interface UsePageDataOptions {
   throttleMs?: number;
@@ -14,7 +14,7 @@ interface UsePageDataResult {
 }
 
 export function usePageData(
-  fetcher: () => Promise<void>,
+  fetcher: (signal?: AbortSignal) => Promise<void>,
   options?: UsePageDataOptions,
 ): UsePageDataResult {
   const throttleMs = options?.throttleMs ?? 5000;
@@ -26,6 +26,14 @@ export function usePageData(
   const lastRunRef = useRef(0);
   const fetcherRef = useRef(fetcher);
   fetcherRef.current = fetcher;
+  const abortRef = useRef<AbortController | null>(null);
+
+  const abort = useCallback(() => {
+    if (abortRef.current) {
+      abortRef.current.abort();
+      abortRef.current = null;
+    }
+  }, []);
 
   const run = useCallback(async (force = false) => {
     if (!enabled || loadingRef.current) return;
@@ -33,11 +41,15 @@ export function usePageData(
     loadingRef.current = true;
     setLoading(true);
     lastRunRef.current = Date.now();
+    abort();
+    const ac = new AbortController();
+    abortRef.current = ac;
     try {
-      await fetcherRef.current();
+      await fetcherRef.current(ac.signal);
     } finally {
       loadingRef.current = false;
       setLoading(false);
+      if (abortRef.current === ac) abortRef.current = null;
     }
   }, [enabled, throttleMs]);
 
@@ -45,6 +57,16 @@ export function usePageData(
     run();
   });
 
+  useDidHide(() => {
+    abort();
+  });
+
+  useEffect(() => {
+    return () => {
+      abort();
+    };
+  }, []);
+
   const trigger = useCallback(() => {
     run(true);
   }, [run]);
@@ -54,11 +76,15 @@ export function usePageData(
     loadingRef.current = true;
     setLoading(true);
     lastRunRef.current = Date.now();
+    abort();
+    const ac = new AbortController();
+    abortRef.current = ac;
     try {
-      await fetcherRef.current();
+      await fetcherRef.current(ac.signal);
     } finally {
       loadingRef.current = false;
       setLoading(false);
+      if (abortRef.current === ac) abortRef.current = null;
     }
   }, []);
 
diff --git a/apps/miniprogram/src/pages/index/index.tsx b/apps/miniprogram/src/pages/index/index.tsx
index 676a424..540e6a7 100644
--- a/apps/miniprogram/src/pages/index/index.tsx
+++ b/apps/miniprogram/src/pages/index/index.tsx
@@ -314,14 +314,25 @@ export default function Index() {
   const modeClass = mode === 'elder' ? 'elder-mode' : '';
 
   // 医护人员访问患者首页时，自动跳转到医生端
+  // 不渲染 HomeDashboard，避免触发患者首页的 API 请求（并发叠加问题）
+  const shouldRedirect = user && isMedicalStaff();
+
   useDidShow(() => {
-    if (user && isMedicalStaff()) {
-      Taro.redirectTo({ url: '/pages/pkg-doctor-core/index' });
+    if (shouldRedirect) {
+      Taro.reLaunch({
+        url: '/pages/pkg-doctor-core/index',
+        fail: () => {
+          console.warn('跳转医生端失败，停留患者首页');
+        },
+      });
     }
   });
 
   if (!user) {
     return <GuestHome modeClass={modeClass} />;
   }
+  if (shouldRedirect) {
+    return <Loading />;
+  }
   return <HomeDashboard modeClass={modeClass} />;
 }
diff --git a/apps/miniprogram/src/pages/index/useHomeData.ts b/apps/miniprogram/src/pages/index/useHomeData.ts
index f944065..e9c2db8 100644
--- a/apps/miniprogram/src/pages/index/useHomeData.ts
+++ b/apps/miniprogram/src/pages/index/useHomeData.ts
@@ -1,4 +1,4 @@
-import { useState, useMemo, useRef } from 'react';
+import { useState, useMemo, useRef, useEffect } from 'react';
 import { useHealthStore } from '@/stores/health';
 import { useAuthStore } from '@/stores/auth';
 import { usePageData } from '@/hooks/usePageData';
@@ -53,6 +53,17 @@ export function useHomeData() {
     enabled: !!user,
   });
 
+  // currentPatient 从 null 变为有值时重新触发加载
+  // 解决 loadPatients 异步完成前 useDidShow 已触发 fetchData 并因 patientId 为空提前返回的问题
+  const prevPatientRef = useRef<string | null>(null);
+  useEffect(() => {
+    const pid = currentPatient?.id ?? null;
+    if (pid && pid !== prevPatientRef.current) {
+      prevPatientRef.current = pid;
+      trigger();
+    }
+  }, [currentPatient?.id, trigger]);
+
   const loadUnread = async () => {
     try {
       const res = await notificationService.getUnreadCount() as { data?: { count?: number } | number };
diff --git a/apps/miniprogram/src/services/auth.ts b/apps/miniprogram/src/services/auth.ts
index 069f09a..2801dd2 100644
--- a/apps/miniprogram/src/services/auth.ts
+++ b/apps/miniprogram/src/services/auth.ts
@@ -48,6 +48,12 @@ export async function wechatBindPhone(openid: string, encryptedData: string, iv:
   });
 }
 
-export async function getPatients() {
-  return api.get<PatientInfo[]>('/health/patients');
+interface PaginatedData<T> {
+  data: T[];
+  total: number;
+}
+
+export async function getPatients() {
+  const res = await api.get<PaginatedData<PatientInfo>>('/health/patients');
+  return Array.isArray(res?.data) ? res.data : (Array.isArray(res) ? res : []);
 }
diff --git a/apps/miniprogram/src/services/health.ts b/apps/miniprogram/src/services/health.ts
index a720df7..8e41177 100644
--- a/apps/miniprogram/src/services/health.ts
+++ b/apps/miniprogram/src/services/health.ts
@@ -17,8 +17,9 @@ export interface TodaySummary {
 }
 
 export async function getTodaySummary(patientId?: string) {
+  const pid = patientId || Taro.getStorageSync('current_patient_id') || '';
   const params: Record<string, string> = {};
-  if (patientId) params.patient_id = patientId;
+  if (pid) params.patient_id = pid;
   return api.get<TodaySummary>('/health/vital-signs/today', params);
 }
 
diff --git a/apps/miniprogram/src/services/request.ts b/apps/miniprogram/src/services/request.ts
index 83ab01b..711dc7e 100644
--- a/apps/miniprogram/src/services/request.ts
+++ b/apps/miniprogram/src/services/request.ts
@@ -56,7 +56,7 @@ class ConcurrencyLimiter {
   }
 }
 
-const limiter = new ConcurrencyLimiter(12);
+const limiter = new ConcurrencyLimiter(8);
 
 // --- Response cache + deduplication ---
 
diff --git a/apps/miniprogram/src/stores/auth.ts b/apps/miniprogram/src/stores/auth.ts
index b8df890..60e4c93 100644
--- a/apps/miniprogram/src/stores/auth.ts
+++ b/apps/miniprogram/src/stores/auth.ts
@@ -114,6 +114,9 @@ export const useAuthStore = create<AuthState>((set, get) => ({
       setCachedPatientId(currentPatient.id);
     }
 
+    // 状态有变化时清理请求缓存，避免返回过期数据
+    clearRequestCache();
+
     // 跳过未变更的 set()
     const cur = get();
     const userChanged = cur.user?.id !== user?.id;
@@ -145,6 +148,7 @@ export const useAuthStore = create<AuthState>((set, get) => ({
         secureSet('tenant_id', user.tenant_id || '');
         set({ user, roles, loading: false });
         clearLoggingOut();
+        get().loadPatients();
         return true;
       }
       secureSet('wechat_openid', resp.openid);
@@ -176,6 +180,8 @@ export const useAuthStore = create<AuthState>((set, get) => ({
       secureSet('tenant_id', resp.user?.tenant_id || tenantId);
       set({ user: resp.user, roles, loading: false });
       clearLoggingOut();
+      // 登录成功后自动加载患者档案（如果有的话）
+      get().loadPatients();
       return true;
     } catch {
       set({ loading: false });
@@ -209,6 +215,7 @@ export const useAuthStore = create<AuthState>((set, get) => ({
       secureRemove('wechat_openid');
       set({ user: tokenData.user, roles, loading: false });
       clearLoggingOut();
+      get().loadPatients();
       return true;
     } catch (err: any) {
       secureRemove('wechat_openid');
diff --git a/apps/miniprogram/src/stores/health.ts b/apps/miniprogram/src/stores/health.ts
index 817f1bd..7cffe3c 100644
--- a/apps/miniprogram/src/stores/health.ts
+++ b/apps/miniprogram/src/stores/health.ts
@@ -1,6 +1,7 @@
 import { create } from 'zustand';
 import * as healthApi from '@/services/health';
 import { getCachedPatientId } from '@/services/request';
+import { useAuthStore } from './auth';
 
 interface CachedTrend {
   data: { date: string; value: number }[];
@@ -37,7 +38,9 @@ export const useHealthStore = create<HealthState>((set, get) => ({
     }
     set({ _refreshingToday: true, loading: true });
     try {
-      const patientId = getCachedPatientId() || undefined;
+      const patientId = getCachedPatientId()
+        || useAuthStore.getState().currentPatient?.id
+        || undefined;
       const data = await healthApi.getTodaySummary(patientId);
       set({ todaySummary: data, todaySummaryFetchedAt: Date.now(), loading: false, _refreshingToday: false });
     } catch {