According to statistics, the incidence of hemorrhoids is about 52.2%, and the main methods of treating hemorrhoids at home and abroad are non-surgical treatment and surgical treatment, and the following is a brief overview of the non-surgical treatment of hemorrhoids. 1, the pathogenesis of hemorrhoids Chinese medicine’s earliest literature “Nei Jing” has a record of hemorrhoids, and put forward the concept of hemorrhoids as tendons (blood vessels) relaxation. Since then, the literature of Chinese medicine has given vivid descriptions of the bleeding and prolapse of hemorrhoids, such as “the blood that comes down is like a line of arrows, or drips and drops”, “intestinal hemorrhoids then change their clothes and come out, and they shrink for a long time”, and also suggested that diet, sedentary, constipation, increased intra-abdominal pressure, emotional and mental state The most important factor for the development of hemorrhoids is diet, sedentary, constipation, increased intra-abdominal pressure, emotional and mental state, diarrhea and dysentery, and pregnancy. In Chinese medicine, hemorrhoids are a result of poor blood flow, blood stasis, heat and blood, and the stagnation of blood and Qi. The main theories are: 1.1 Varicose veins theory McGivey (1967) and Nesselrod (l974) believed that chronic inflammation causes venous dilatation; Parks (1956) believed that hard fecal masses block the proximal venous return and cause stasis and dilatation of the anal canal veins. Stewart (1963) modified Parks’ theory by suggesting that the increase in abdominal pressure caused by the nuisance blocked venous reflux. 1.2 Vascular proliferation theory In the 19th century, hemorrhoids were considered to be an erectile-like tissue. 1963 Stelzne introduced the concept of corpus cavernosum recti (rectal cavernous body), which was considered to be caused by proliferation of the rectal cavernous body. 1.3 Theory of inferior displacement of anal cushion In 1975 Thomson proposed the theory of inferior displacement of anal cushion, suggesting that the anal cushion is a normal anatomical structure of the anal canal, located on the left, right anterior and right posterior sides, consisting of dilated venous plexus, smooth muscle (Treitz’s muscle) and elastic and knotted tissues, which mainly plays the role of closing the anus, indicating that a significant proportion of patients after hemorrhoidectomy have anal The reason for the impaired self-control function. When the Treitz’s muscle gradually degenerates and breaks, the anal cushion loses its support and migrates downward to form hemorrhoids or hemorrhoids. hyams and Philpott (1970) suggested that defecation straining and irregular bowel habits are responsible for the downward migration of the anal cushion and stasis of blood. 1.4 Theory of decreased sphincter function This theory suggests that due to the decreased function of the anal sphincter, the tissue structure is relaxed, resulting in a decrease in anal canal pressure, and in order to maintain the anal canal pressure constant, the local hemorrhoidal venous plexus compensates for the expansion of stasis and the formation of hemorrhoids. 2, non-surgical treatment of hemorrhoids 2.1 Ligation, ligature Ligation therapy is an ancient method of treating hemorrhoids, domestic and foreign literature, which has been recorded. The “Fifty-two Disease Formula” excavated from the Mawangdui Han Tomb in Changsha has the record of “the peony hemorrhoid living next to the orifice, large as a date, …… tied with a small rope and carved with a knife”. For internal hemorrhoids, the base of the hemorrhoid is tied with a silk thread to block the blood supply so that the tissue will naturally fall off due to ischemic necrosis and remove the hemorrhoid lesion. Ligation and ligature must be treated in stages for multiple hemorrhoids and circumferential mixed hemorrhoids, which are effective for internal hemorrhoids. Disadvantages: This method takes relatively long to treat, is painful for patients, is not suitable for external hemorrhoids and mixed hemorrhoids, and can easily cause heavy bleeding when the ligation or ligature is not secure or the hemorrhoid falls off. Too much ligation and ligature can easily cause anal stenosis. Foreign Blaisdell first reported internal hemorrhoid ligation therapy (silk thread) in 1958. 1963 Barronc improved the technique by applying rubber ring ligation. 1984 Goligher favored simultaneous ligation of 3 internal hemorrhoids and emphasized that ligation should be performed at a level as close to the anal ring as possible to avoid postoperative discomfort. The ligature therapy can cause obstruction of blood circulation in the anal region, which can lead to bruising and edema, pain, and difficulty in defecation. The literature reports a 0.8%-15% incidence of bleeding, a l% incidence of abscess, and a 0.5% incidence of anal stricture after adhesive ring ligation, and Rothberg reports an 80% cure rate at 5-15 years follow-up. 2.2 Withered hemorrhoid therapy Withered hemorrhoid therapy is one of the traditional therapies of motherland medicine and is also an erosion therapy, currently there are two methods in China, namely withered hemorrhoid dispersion therapy Applicable to the treatment of stage III internal hemorrhoids and embedded internal hemorrhoids, withered hemorrhoid dispersion is applied to the surface of the hemorrhoid mass, causing the hemorrhoid to necrosis, dry up and fall off, and the wound heals itself. It contains alum, white arsenic, stannum and moonstone, etc. Because it contains arsenic, it is easy to be poisoned in the treatment, so later people changed it to arsenic-free hemorrhoid treatment. The hemorrhoid nail therapy is also called inserting medicine therapy, the hemorrhoid nail contains white arsenic, alum, cinnabar, andrographis, myrrh, etc., but later people improved it by using rhubarb, cypress and hyacinth, etc., to make the hemorrhoid nail without arsenic. Since the nail contains alum, it is easy to cause bleeding after inserting the nail and the patient suffers a lot of pain, so it is gradually replaced by modern medicine. 2.3 Sclerotherapy injection Born in England more than 100 years ago, injection therapy is another hemorrhoid treatment method between surgery and medicine. 1896 Mathews first applied phenol to inject oil to treat internal hemorrhoids, Kelsey (US) and Edwards (UK) thought that injection of phenol oil was beneficial, diluting phenol to 5%~7.5%. The injection method is to inject 5% phenol vegetable oil (olive oil or cottonseed oil) into the submucosa at the tip of the hemorrhoid nucleus to fill the nucleus until the vascular texture is clearly visible, injecting 2~3ml in each quadrant, and repeating l times each after l and 3 months, with no further injection at the hard nodes. However, the actual effect of this therapy depends directly on the drug injected, and the two types of sclerosing and necrotizing agents currently used are classified according to their pharmacological effects, which are injected directly into the hemorrhoid or lead to necrosis and shedding or sclerosis and atrophy. With the increasing expectations for this treatment, higher concentrations and larger doses are often used during injection to improve efficacy, and as a result, the disadvantages of sclerosing necrotizing agents are slowly revealed, and postoperative mucosal erosion, local hemorrhage and rectal stricture are becoming more common in the clinic. The adverse effects of sclerosing necrotizing agents restricted the further development of injection therapy. 2.4 Anal dilation In 1968, Lord promoted the application of anal dilation for the treatment of internal hemorrhoids by inserting the 2 fingers of one hand and the index finger of the other hand into the anus, gently dilation and tearing the fibrous band (commonly used for stage III internal hemorrhoids), and dilation until the anus can accommodate more than 4 fingers.Greve and Hubens showed a decrease in anal pressure after dilation, but there is a risk of anal incontinence, especially in elderly patients, so it has been It is rarely used in the United States, but is still used in the United Kingdom. However, Konsten reported that anal incontinence occurred in nearly half of the patients after 17 years of dilation (Lord’s roocdure) and concluded that dilation for internal hemorrhoids should be abandoned. 2.5 Cryopreservation In 1969 Lewis reported the application of liquid nitrogen (.196 degrees) to freeze both internal and external hemorrhoids. The disadvantages were difficulty in eliminating external hemorrhoids, long healing time, and pain and discharge. 1982 Oh recommended freezing only for internal hemorrhoids and not for treating stage IV internal hemorrhoids, and since then there have been no reports on this, and the method is now obsolete. 2.6 Laser treatment of hemorrhoids is based on the principle of using optical energy to produce high temperatures to carbonize and cut the hemorrhoidal tissue, using the laser beam to irradiate the nucleus of the hemorrhoid to produce carbonized necrosis and detachment of the irradiated hemorrhoid. Therefore, while the nucleus of the hemorrhoid is removed using the laser, the surface of the trauma left behind is also necrotic due to high-temperature cauterization, causing great pain to the patient after surgery and even endangering the patient’s life, and the trauma only begins to heal after the scab falls off, so healing time is greatly delayed. Disadvantages: The wound heals very slowly, and if the depth is not well controlled, other tissues are easily damaged. Multiple hemorrhoids cannot be treated at once and need to be treated in stages. Scarring is serious after healing. In the late 1980s, the laser was used more in anorectal treatment in China, but after several years of clinical use, it is rarely used anymore. Because the heat of laser is transmitted by the center of action to the surrounding diffusion, there is no obvious temperature difference boundary between the action site and the non-action site, and it is easy to cause surrounding edema after treatment. 2.7 Microwave therapy has been used for many years at home and abroad, its efficacy has been affirmed by the medical profession, when the microwave action on the body tissue, causing high-frequency oscillations of ions, water molecules and dipoles in tissue cells. When the microwave energy is low, low heat production, enhance local blood circulation, accelerate local metabolism, enhance local immunity, can effectively improve local blood circulation, promote the absorption of edema, anti-inflammatory pain; when the microwave energy is high, high heat production, protein denaturation, coagulation, necrosis, and even charring, is very easy to cause postoperative bleeding. 2.8 Infrared coagulation therapy Neiger was the first to report the application of infrared coagulation for the treatment of internal hemorrhoids in 1979. leicester et al. compared infrared therapy and ligation therapy through a randomized study and concluded that infrared therapy is effective for stage I and II internal hemorrhoids. A meta-analysis conducted by Johanson and Rimm studying infrared therapy, collar ligation and sclerotherapy injection concluded that collar ligation was more effective in the long term than the other two methods, but due to pain and other rare complications, they concluded that infrared therapy should be chosen for the treatment of stage I and II hemorrhoids. In contrast, the experience of Salvati et al. advocates ligation over infrared therapy. 2.9 Iontophoresis The principle of local DC electrolysis causes local ionization reactions in hemorrhoids, producing H+ and Cl. The high acidic local environment causes vasoconstriction and occlusion within the hemorrhoid, thus blocking the blood supply to the hemorrhoid to achieve the purpose of treatment. Disadvantages: Theoretically feasible, but the practical application is not ideal. The treatment time is long. 2.10 Electrotherapy In 1987 some gastroenterologists introduced electrotherapy for the treatment of internal hemorrhoids, all stages of internal hemorrhoids can be treated with electrotherapy by placing a pair of probe tips) at the base of the internal hemorrhoids, increasing the current to 2mA, then inserting the probe into the tissue 2~3mm, increasing the current plug to 10~16mA, and keeping the probe in place for 10min. 2 treatments in total, l times every other week. l991 In a prospective comparative study, Wright et al. found that the recent follow-up results of electrotherapy were superior to drug therapy, but the long-term follow-up results are not yet certain. This method is not suitable for the treatment of mixed and external hemorrhoids in patients with bleeding as the main symptom in the early stage of internal hemorrhoids; it is also ineffective in late stage internal hemorrhoids and ineffective in stage II and III fibrotic internal and mixed hemorrhoids with prolapse as the main symptom. 2.11 Radiofrequency therapy is to produce strong molecular movement through the action of radiofrequency electromagnetic waves on tissue cells, forming a special endogenous heat effect (generally 60℃～80℃), using low temperature to make tissue protein coagulation, thrombus formation in the hemorrhoid nucleus, vascular occlusion, through tissue absorption, to achieve the treatment purpose of hemorrhoid nucleus atrophy, flattening and disappearance. This therapy mainly controls the heat production time of hemorrhoid nucleus by artificial pre-setting method, which cannot achieve the best treatment effect. 2.12 Bipolar thermal coagulation therapy In 1987 Griffith applied this technique to treat stage I and II hemorrhoids with the aim of necrosis of hemorrhoidal tissue through heating. 1996 Dennison et al. applied this method to treat internal hemorrhoids in more than a thousand cases and considered it superior to glue ring ligation or infrared coagulation therapy, representing the development direction of non-surgical treatment of hemorrhoids. 2.13 High frequency capacitive field (HCTP) treatment In 1995, China gradually began to apply high frequency capacitive field technology to treat hemorrhoids. High-frequency capacitive field principle: when the capacitive field acts on the human body, the tissue between the positive and negative electrodes in the high-density, high-frequency alternating electric field in the tissue electrolyte ions move in the direction of the power line, when the high-frequency electric positive half-week, positive ions are pushed by the positive pole to the negative pole, negative ions are attracted, in the negative half-week, the opposite. Due to this high frequency polarity change, the ions are repelled at one moment and attracted at the next, resulting in a kind of ion oscillation moving back and forth along the power line direction between the electrodes. Since the size, mass, charge and speed of various ions are different, they generate heat by rubbing against each other and against the surrounding medium during the oscillation. 2.14 Bioelectrical impedance measurement (BEIM) technology treatment Patented by Saiford Electronic Equipment Co., Ltd. in 2002, bio.electrical impedance measurement (BEIM) applied to human tissue measurement is a new technology developed in recent years, which is a non-invasive method for detecting human information. It is a non-invasive method of human body information detection, which uses the difference in electrical conductivity of the tissues of each part of the organism to make electrophysiological measurement of biological tissues. When the signal frequency is constant, the bioelectrical impedance is related to the volume of the conductor. When the high-frequency bipolar electric clamp clamp hemorrhoid nucleus tissue heat treatment, reasonable adjustment of the instrument output impedance, the electric clamp rapid heat generation so that the nucleus tissue in the rapid evaporation of water, in the process of bioelectric impedance from small to large, when the nucleus tissue electrical impedance value and the instrument output impedance value match, the tissue instantaneous dry knot, then the output power straight down, and automatic beep prompt, to ensure that the tissue dry knot does not carbonize that the best treatment effect. Its characteristics are: uniform heating site, instant coagulation dry junction, dry junction site boundary is clear, excellent hemostatic effect, and no charring, safety is very high. After clinical application, it is very popular and supported by the majority of medical workers, solving the medical problem of postoperative bleeding of patients and the current technical problem of artificial time setting.