diff --git a/crates/erp-health/src/service/appointment_service.rs b/crates/erp-health/src/service/appointment_service.rs
index 1cc2196..f082af9 100644
--- a/crates/erp-health/src/service/appointment_service.rs
+++ b/crates/erp-health/src/service/appointment_service.rs
@@ -154,10 +154,9 @@ pub async fn create_appointment(
     let txn = state.db.begin().await?;
 
     // 原子 CAS: 排班名额 +1
-    // 注意: CAS 按 (tenant_id, doctor_id, schedule_date, start_time) 匹配。
-    // 唯一索引在 (tenant_id, doctor_id, schedule_date, period_type) 上。
-    // 这要求同一医生同一天同一 start_time 只有一个排班记录，否则 CAS 可能递增错误的行。
-    // 当前业务逻辑保证: 每个医生每天每个时间段最多一条排班。
+    // CAS 按 (tenant_id, doctor_id, schedule_date) + 时间范围匹配：
+    // 排班的 start_time <= 预约 start_time 且排班的 end_time >= 预约 end_time，
+    // 即预约时段落在排班时段内即可。rows_affected 必须恰好为 1（同一医生同一天不应有时段重叠）。
     let cas_result = doctor_schedule::Entity::update_many()
         .col_expr(
             doctor_schedule::Column::CurrentAppointments,
@@ -167,7 +166,8 @@ pub async fn create_appointment(
         .filter(doctor_schedule::Column::TenantId.eq(tenant_id))
         .filter(doctor_schedule::Column::DoctorId.eq(doctor_id_val))
         .filter(doctor_schedule::Column::ScheduleDate.eq(req.appointment_date))
-        .filter(doctor_schedule::Column::StartTime.eq(req.start_time))
+        .filter(doctor_schedule::Column::StartTime.lte(req.start_time))
+        .filter(doctor_schedule::Column::EndTime.gte(req.end_time))
         .filter(
             Condition::all()
                 .add(doctor_schedule::Column::DeletedAt.is_null())
@@ -183,6 +183,16 @@ pub async fn create_appointment(
         txn.rollback().await?;
         return Err(HealthError::ScheduleFull);
     }
+    if cas_result.rows_affected > 1 {
+        txn.rollback().await?;
+        tracing::error!(
+            doctor_id = %doctor_id_val,
+            date = %req.appointment_date,
+            matched = cas_result.rows_affected,
+            "CAS matched multiple schedules — overlapping schedule data"
+        );
+        return Err(HealthError::Validation("排班数据异常：存在重叠时段，请联系管理员".to_string()));
+    }
 
     let now = Utc::now();
     let active = appointment::ActiveModel {
@@ -554,7 +564,7 @@ pub async fn send_reminders(
     db: &sea_orm::DatabaseConnection,
     event_bus: &erp_core::events::EventBus,
 ) -> crate::error::HealthResult<usize> {
-    use chrono::{Local, NaiveDate};
+    use chrono::Local;
     use serde_json::json;
 
     let tomorrow = Local::now().date_naive() + chrono::Duration::days(1);