Abstract： Objective： To observe the clinical efficacy of Yu'ermin Decoction in the treatment of patients with chronic spontaneous urticaria （CSU） of wind-damp-heat type and its effect on serum immune markers. Methods：A total of 72 CSU patients of wind-damp-heat type who visited the Dermatology Department of Gulin County Hospital of Traditional Chinese Medicine from November 2023 to July 2024 were randomly divided into the treatment group and the control group （36 cases each）. The control group received Loratadine Tablets alone； the treatment group received Loratadine Tablets combined with Yu'ermin Decoction. Both groups were treated for four weeks and followed up for two weeks. Clinical efficacy， 7-day Urticaria Activity Score （UAS7）， Visual Analogue Scale （VAS） for pruritus， Dermatology Life Quality Index （DLQI），and serum immune markers [serum levels of interleukin （IL）-17A，IL-23， IL-33， tumor necrosis factor- α（TNF- α）， interferon- γ （IFN- γ）] were compared between the two groups after treatment. Results： After treatment， the total effective rate was 94.44% （34/36） in the treatment group and 83.33% （30/36） in the control group， with the difference being significant （P＜0.05）. Repeated-measures ANOVA showed significant differences in terms of UAS7 scores for group， time， and group × time interaction effects （P＜ 0.05）；UAS7 scores at every time point and between each pair of adjacent time points in the treatment group decreased compared to before treatment（ P＜0.05）. In the control group，there was no significant difference between week one and week two of follow-up （P＞0.05）. The treatment group demonstrated significantly lower scores than the control group only at the two-week treatment time point and the two-week follow-up point （P＜0.05）. Both groups exhibited a significant decreasing trend in VAS scores for pruritus，with statistically significant main effects of group，time，and group × time interaction （P＜0.05）. The treatment group's VAS scores decreased from 8.44 ± 1.13 to 1.94 ± 1.01， showing significant reductions at all time points compared to before treatment （P＜0.05）. The control group's VAS scores also decreased from 8.28 ± 0.94 to 3.08 ± 1.38，with significant reductions at all time points compared to before treatment （P＜0.05），although the magnitude of decrease was smaller than that in the treatment group. The treatment group had significantly lower VAS scores than the control group at week one of treatment， and weeks one and two of follow-up（ P＜0.05）. For DLQI scores，both groups showed a decreasing trend with significant main effects of time and group （P＜0.05）， but the group × time interaction was not significant （P＞0.05）. The mean DLQI score in the treatment group decreased from 25.08 ± 3.41 to 5.31 ± 2.07，while that in the control group decreased from 24.72 ± 2.94 to 7.83 ± 2.83. Scores at all time points were significantly lower than those before treatment in both groups （P＜0.05）. The treatment group had significantly lower DLQI scores than the control group at treatment weeks three and four，and follow-up weeks one and two （P＜0.05）. After treatment， IFN- γ levels in the treatment group were significantly increased compared to before treatment （P＜0.05）， while levels of IL-33， IL-17A， IL-23， and TNF- α were significantly decreased （P＜0.05）. In the control group，levels of IL-23，IL-33，and TNF-α decreased compared to before treatment （P＜0.05），and IFN-γ levels increased compared to before treatment （P＜0.05），but the change in IL-17A was not statistically significant （P＞0.05）. After treatment， the IL-17A levels in the treatment group were significantly lower than those in the control group （P＜0.05）， while the differences in IL-33， IL-23， and TNF-α between the two groups were not statistically significant （P＞0.05）. Conclusion： The combination of Loratadine Tablets and Yu'ermin Decoction in treating CSU of wind-damp-heat type can alleviate clinical symptoms， modulate immune imbalance，and improve patients' quality of life.