To analyze the effect of Qufeng Paidu Zhiyang decoction medicated bath on uremia patients with skin pruritus. Methods A total of 80 patients with uremia who received dialysis treatment in Zhenjiang Hospital of Traditional Chinese Medicine from October 2022 to October 2023 were selected as the research objects. All patients had skin pruritus complications during dialysis. According to the time of admission, they were divided into control group and observation group, with 40 patients in each group. The control group was treated with loratadine tablets orally, and the observation group was treated with Qufeng Paidu Zhiyang decoction medicated bath combined with loratadine tablets orally. The symptom scores, serological indicators and clinical efficacy of the two groups were compared. Results After treatment, the pruritus symptom score and secondary skin lesion symptom score in the observation group were lower than those in the control group (P <0.05). After treatment, the levels of serum IL-2, TNF-α, IgE, P and Ca in the observation group were lower than those in the control group (P <0.05). The total effective rate of treatment in the observation group was 90.00%, which was higher than 70.00% in the control group (P <0.05). Conclusion Qufeng Paidu Zhiyang decoction medicated bath combined with loratadine tablets has a good effect on the treatment of skin pruritus in uremic, which can effectively improve the body's calcium and phosphorus metabolism, repair the inflammatory response, and reduce the symptoms of dialysis-related skin pruritus.