diff --git a/hlw/automation/config.js b/hlw/automation/config.js
index 67c1a78..5adda0b 100644
--- a/hlw/automation/config.js
+++ b/hlw/automation/config.js
@@ -8,6 +8,8 @@ const DEFAULT_AUTOMATION_CONFIG = {
   autoAcceptOrder: false,
   autoOpenRx: false,
   autoPassRx: false,
+  // Preserve the existing behaviour for institutions with no saved value.
+  enableRationalDrug: true,
   autoAcceptDelayMinSeconds: 2,
   autoAcceptDelayMaxSeconds: 5,
   autoOpenRxDelayMinSeconds: 20,
@@ -73,6 +75,7 @@ function normalizeAutomationConfig(config = {}) {
   result.autoAcceptOrder = config.autoAcceptOrder === true;
   result.autoOpenRx = config.autoOpenRx === true;
   result.autoPassRx = config.autoPassRx === true;
+  result.enableRationalDrug = config.enableRationalDrug !== false;
   return result;
 }
 
diff --git a/hlw/automation/config.test.js b/hlw/automation/config.test.js
index ce6bdaa..ff5aca7 100644
--- a/hlw/automation/config.test.js
+++ b/hlw/automation/config.test.js
@@ -12,6 +12,7 @@ describe("automation config", () => {
       autoAcceptOrder: false,
       autoOpenRx: false,
       autoPassRx: false,
+      enableRationalDrug: true,
       autoAcceptDelayMinSeconds: 2,
       autoAcceptDelayMaxSeconds: 5,
       autoOpenRxDelayMinSeconds: 20,
diff --git a/hlw/diagnostic-record/index.js b/hlw/diagnostic-record/index.js
index d27cbd7..bb9f693 100644
--- a/hlw/diagnostic-record/index.js
+++ b/hlw/diagnostic-record/index.js
@@ -2146,10 +2146,27 @@ async function getRxMedicineOrderStatus(ctx, db) {
 
 async function getYbReviewResult(ctx, db) {
   const params = ctx && ctx.params && typeof ctx.params === "object" ? ctx.params : {};
+  const corpId = typeof ctx.corpId === "string" ? ctx.corpId.trim() : "";
+
+  try {
+    // The switch is deliberately checked here so every caller (manual and
+    // automated prescribing) has one consistent rational-drug-review policy.
+    if (corpId) {
+      const config = await db.collection("hlw-config").findOne(
+        { corpId },
+        { projection: { enableRationalDrug: 1 } }
+      );
+      if (config && config.enableRationalDrug === false) {
+        return { success: true, message: "未开启合理用药，已跳过合理用药" };
+      }
+    }
+  } catch (e) {
+    return { success: false, message: `查询合理用药配置失败: ${e.message}` };
+  }
+
   const orderId = typeof params.orderId === "string" ? params.orderId.trim() : "";
   const drugs = Array.isArray(params.drugs) ? params.drugs : [];
   const diagnosisList = Array.isArray(params.diagnosisList) ? params.diagnosisList : [];
-  const corpId = typeof ctx.corpId === "string" ? ctx.corpId.trim() : "";
 
   if (!orderId) {
     return { success: false, message: "订单号不能为空" };
diff --git a/hlw/hlw-config/index.js b/hlw/hlw-config/index.js
index f72fc3e..968102a 100644
--- a/hlw/hlw-config/index.js
+++ b/hlw/hlw-config/index.js
@@ -43,6 +43,7 @@ async function getHlwOrderConfig({ corpId }) {
           autoAcceptOrder: 1,
           autoOpenRx: 1,
           autoPassRx: 1,
+          enableRationalDrug: 1,
           autoAcceptDelayMinSeconds: 1,
           autoAcceptDelayMaxSeconds: 1,
           autoOpenRxDelayMinSeconds: 1,
@@ -79,6 +80,7 @@ async function updateHlwOrderConfig(ctx) {
       autoAcceptOrder,
       autoOpenRx,
       autoPassRx,
+      enableRationalDrug,
     } = ctx;
     const data = {}
     if (typeof payDuration == 'number') {
@@ -121,6 +123,9 @@ async function updateHlwOrderConfig(ctx) {
     if (typeof autoPassRx === 'boolean') {
       data.autoPassRx = autoPassRx;
     }
+    if (typeof enableRationalDrug === 'boolean') {
+      data.enableRationalDrug = enableRationalDrug;
+    }
 
     if (AUTOMATION_DELAY_KEYS.some((key) => key in ctx)) {
       const current = await db.collection("hlw-config").findOne(