Urticaria is also known as “rubella”, or “addiction rash” in Chinese medicine. The clinical manifestations are congested erythema, wind masses with itching, and in severe cases, abdominal pain, laryngeal edema leading to respiratory distress and anaphylaxis. Chronic urticaria is a condition that occurs frequently and lasts for more than 6 weeks. Chronic urticaria is a common disease in dermatology and one of the most difficult to treat clinically. Treatment with Western medicine alone is often ineffective. In our department, we have used a combination of Chinese and Western medicines in long-term clinical practice, which can significantly improve the efficacy of treatment. I. The causes of urticaria are various allergens in the diet and external environment, drugs, infections (bacteria, viruses, fungi, parasites, etc.), physical factors (cold, heat, sunlight, exercise, etc.), and as skin manifestations of systemic diseases (rheumatic and connective tissue diseases, thyroid diseases, tumors, etc.). However, the etiology of chronic urticaria is often difficult to determine. Its onset may be the result of a combination of etiologies, or it may have a strong relationship with the immune status of the organism itself. Chinese medicine etiology: congenital deficiency of endowment, or surface deficiency, wind-cold, wind-heat external attack, guest in the muscle surface; poor diet, resulting in gastrointestinal damp heat; liver and kidney deficiency, blood deficiency, wind-generated dryness, etc. The classification of urticaria and Chinese medicine identification of idiopathic urticaria (acute, chronic), physical urticaria (cold, heat, pressure, sunlight, artificial urticaria), infectious urticaria, autoimmune urticaria, other (cholinergic, water, etc.). They are divided into: wind-cold superficial evidence, wind-heat offending evidence, gastrointestinal damp-heat evidence, blood deficiency and wind-dry evidence, etc. Laboratory tests: routine blood tests, allergen tests. If necessary, H. pylori test, stool routine, thyroid function, immune function, blood sedimentation, autoantibodies and tumor examination, etc. When urticarial vasculitis is considered, histopathological examination is done. Treatment of chronic urticaria Try to remove the possible causes, including allergens, physical factors, infections, etc. Systematic oral treatment is the mainstay, with a combination of western medicine plus herbal medicine. The general treatment principle is to first control the symptoms with sufficient medication, and then the medication is gradually reduced in a stepwise manner until it is discontinued. In the process of dose reduction, when the symptoms come back, the dose needs to be adjusted. Some people require long-term oral maintenance at low doses. The individualized treatment plan, i.e., the choice of therapeutic drugs, dose reduction and maintenance medication and dose, and duration of treatment are different for each patient. 1. Topical medication. Adjunctive treatment. Furfurylated lotion. Homemade compound bitter ginseng lotion can clear heat, dry dampness and stop itching. Homemade compound aluminum acetate applicator has good cooling and anti-itching and astringent effect. 2. Oral antihistamines. The first generation of antihistamines include ketotifen, paracetamol, cyproheptadine, doxorubicin and so on. The second generation of antihistamines has a wide variety. The first generation antihistamines have the side effect of drowsiness and can be taken at bedtime. Second-generation antihistamines are the first-line basic medications. Depending on the patient’s condition, a combination of first-generation antihistamines is used. Add an H2 receptor antagonist such as cimetidine if necessary. Add trinostat if necessary. 3. Drugs that regulate immune function. BCG polysaccharide nucleic acid injection, intramuscular injection, for 3-6 months, can improve immune function and change allergic status. Pafoline, 3-6 months. Compound glycopyrrolate (Mennen) tablet or injection. 4.Sodium thiosulfate, calcium gluconate, vitamin C, intravenous push. 5.Systemic antibiotics can be used in case of combined bacterial infection. 6.TCM identification treatment. According to the patient’s performance and the course of the disease, identify the medicine. 7.Chinese patent medicine. Skin Itch Granules (dispel wind and dampness, activate blood to relieve itch), Damp Poison Qing (nourish blood, clear heat and dampness, dispel wind), Baixian Xia Ta Hot Tablets (clear heat and dampness, laxative), Anti-wind and Anti-itch Granules (dispel wind and dampness), Run Dry and Anti-itch Capsules (nourish blood and dispel wind), etc.