慢性湿疹的临床表现以瘙痒及皮损改变如斑疹、渗出、脱屑、皮肤增厚等为特征，传统中医多从风、湿、热邪致病 认识慢性湿疹，治疗多从祛风、除湿、清热入手，而对慢性湿疹合并的情志改变、睡眠障碍的论治较少。该文将形气神三 位一体生命观与脏腑辨证相结合，根据慢性湿疹临床病症特点，提出脾之运化失司是慢性湿疹的发病基础，心肝功能异常 是影响湿疹转归的重要因素；治疗时可从发病特点、病程长短、皮损特点等方面着手，将调形气神与从心肝脾论治相结合， 以期改善慢性湿疹患者的临床症状及生活质量，提高疗效。

Chronic eczema is clinically characterized by pruritus and skin lesions such as macules，exudation， desquamation， and lichenification. Traditional Chinese medicine（TCM） typically attributes its pathogenesis to wind， dampness， and heat pathogens， and TCM treatment for chronic eczema focused on dispelling wind， eliminating dampness，and clearing heat. However，there were fewer reports about the treatment of accompanying emotional changes and sleep disturbances in chronic eczema patients. This paper integrated the physique-qi-spirit trinity life view with zang-fu organ differentiation， and proposed that the disorder of spleen transportation and transformation contributed to the pathological foundation of chronic eczema，while the dysfunction of heart and liver was the factor that significantly influenced disease progression after analyzing the clinical features of chronic eczema. For the treatment of chronic eczema， the establishment of strategies should consider clinical characteristics， duration of disease，and skin lesion patterns. The combination of physique-qi-spirit regulation with heart-liverspleen treatment approaches aims to alleviate clinical symptoms，improve quality of life，and enhance therapeutic efficacy for chronic eczema patients.

R275.9

深圳市科技计划项目（编号：JCYJ20230807094817036）；深圳市中医院“3030”计划中医临床研究项目（编号：G3030202105）； 广东省针灸学会科研课题项目（编号：GDZJ2022008）；杨卓欣全国名老中医传承工作室建设项目（国中医药人教函〔2022〕75号）