Chronic urticaria (CU) is defined as the recurrent appearance of wheals (hives), angioedema, or both on an almost daily basis for more than six weeks.

慢性蕁麻疹指的是風團（蕁麻疹）、血管性水腫，或兩者反覆出現，且幾乎每日發作、持續超過六週的狀態。

CU is broadly classified into chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIU).

慢性蕁麻疹可分為慢性自發性蕁麻疹（CSU）與慢性誘發性蕁麻疹（CIU）。

CSU occurs without identifiable external triggers, whereas CIU is provoked by specific physical or environmental stimuli such as pressure, temperature changes, water, or sunlight.

CSU 為無明確外在誘因的自發性發作，而 CIU 則由特定刺激（如摩擦、壓力、冷熱、水或日光）誘發。

Second-generation H1-antihistamines are recommended as first-line therapy, yet a substantial proportion of patients remain symptomatic despite dose escalation.

第二代 H1 抗組織胺為第一線治療，但即使加量，仍有相當比例患者症狀無法控制。

This suggests that histamine is not the sole mediator in CU; immune dysregulation, mast cell hyperreactivity, cytokine release, and neuro-immune interactions also play critical roles.

這顯示蕁麻疹的病理機轉不僅限於組織胺，還涉及免疫失衡、肥大細胞過度活化、細胞激素釋放與神經—免疫交互作用。

Consequently, purely antihistaminic strategies may be insufficient for long-term disease control in some patients.

因此，單一以抗組織胺為主的策略，對部分患者而言並不足以達成長期控制。

Given the limitations, costs, and accessibility issues of advanced pharmacologic therapies such as omalizumab and cyclosporine A, there is growing interest in non-pharmacological approaches.

由於進階藥物治療（如 omalizumab、環孢素 A）價格高昂且可近性有限，非藥物療法逐漸受到關注。

Acupuncture has been widely used as an antipruritic intervention in dermatologic conditions, including urticaria, and has shown potential immunomodulatory and anti-inflammatory effects.

針灸長期應用於多種皮膚疾病止癢治療，並顯示可能具備免疫調節與抗發炎作用。

However, existing evidence has been limited by methodological weaknesses, prompting the need for rigorously designed randomized controlled trials.

然而，既有研究多存在方法學限制，因此需要嚴謹設計的隨機對照試驗加以驗證。

CU is a chronic, relapsing condition that significantly impairs quality of life and productivity, often requiring long-term management strategies.

慢性蕁麻疹具有反覆發作、病程長的特性，對生活品質與工作效率造成顯著影響。

Acupuncture offers a low-risk, non-pharmacological option that may complement standard care by targeting neuro-immune regulation rather than a single biochemical pathway.

針灸提供一種低風險、非藥物的選項，其作用重點在於調節神經—免疫系統，而非單一化學路徑。

1. Head Points – Central Regulation

一、頭部穴位：中樞調節

Points such as GV20 (Baihui), GV24 (Shenting), GV23 (Shangxing), and GV21 (Qianding) were selected to modulate central nervous system activity and stress-related triggers.

百會、神庭、上星、前頂等頭部穴位，主要用於調節中樞神經活動與壓力相關誘發因子。

2. Heat-Clearing and Antipruritic Points

二、清熱止癢穴位

LI11 (Quchi) and SP10 (Xuehai) are classically associated with clearing heat, cooling blood, and alleviating pruritus in dermatologic disorders.

曲池與血海在傳統與現代臨床中，皆常用於清熱、涼血與止癢相關皮膚病變。

3. Immune and Systemic Regulation Points

三、免疫與全身調節穴位

ST36 (Zusanli) and SP6 (Sanyinjiao) were included to support immune modulation, systemic balance, and inflammatory regulation.

足三里與三陰交主要用於免疫調節、全身平衡與慢性發炎狀態的調控。

4.Gastrointestinal regulating points

四、胃腸功能調節穴位

CV12 (Zhongwan) is located on the anterior midline of the upper abdomen and with ST36 (Zusanli) are traditionally regarded as a key point for regulating gastrointestinal function and systemic immune balance.

中脘位於上腹部前正中線，在傳統臨床中和足三里一起被視為調節胃腸功能與全身免疫平衡的重要穴位。

Increasing evidence suggests that gastrointestinal function and mucosal immune activity are closely linked to chronic inflammatory and allergic conditions, including chronic urticaria.

越來越多研究指出，胃腸功能與黏膜免疫活性與慢性發炎與過敏性疾病（包括慢性蕁麻疹）密切相關。

These points appear consistently across both traditional clinical practice and modern trials due to their reproducible effects on inflammation, immune activity, and pruritus.

這些穴位在傳統臨床與現代研究中反覆出現，因其在抗發炎、免疫調節與止癢方面具有高度可重現性。

Their inclusion enhances both biological plausibility and external validity in acupuncture trials.

納入這些穴位，有助於提升研究的生物學合理性與外部效度。