【Abstract】Objective: To evaluate the efficacy of Hemorrhoidal Cleansing Formula on the treatment of postoperative mixed hemorrhoids patients with local granulation tissue edema, wound pain, and bleeding during defecation. Methods: There were 60 cases in the treatment group and 60 cases in the control group; the treatment group was treated by fumigation with Hemorrhoidal Cleansing Formula, and the control group was treated by fumigation with Jinxuan Hemorrhoidal Fumigation San. Results: At 3 days and 7 days of medication, the difference of edema and pain scores between the treatment group and the control group was obvious and statistically significant (P<0.05)< font="">, and the efficacy of the treatment group was better than that of the control group; whereas the difference of the blood in stool scores was not obvious and statistically significant (P>0.05), and the efficacy of the treatment group was comparable to that of the control group. Conclusion: Hemorrhoidal washing formula has significant efficacy in reducing local granulation tissue edema, wound pain, and bleeding during defecation in postoperative patients with mixed hemorrhoids. Keywords: hemorrhoidal washing formula; fumigation; mixed hemorrhoids; postoperative complications Mixed hemorrhoids is a common and frequent disease in anus and intestinal department, which is related to dietary irregularities, prolonged sitting and standing, excessive fatigue, irregular life, excessive sexual intercourse, pregnancy, and bad life habits. There are only two ways of treatment: conservative and surgical. For those patients for whom conservative treatment is not effective, surgery is the only solution. External peeling and internal ligation is one of the commonly used surgical methods for the treatment of mixed hemorrhoids. After the surgery, due to the open wound and frequent contamination by feces, the local granulation tissue edema, wound pain, and bleeding during defecation are the biggest mental burdens for the patients. Our department’s self-designed hemorrhoidal washing formula has played a good clinical efficacy in treating the symptoms of postoperative mixed hemorrhoids, such as local granulation tissue edema, wound pain, bleeding during defecation, and so on. From April 2012 to August 2013, a total of 120 hospitalized cases were collected from our department, and Jinxuan Hemorrhoidal Fumigation Powder was used as a control comparison for the clinical observation of patients’ postoperative anal local edema, pain, blood in stool and other complications. Report as follows: 1, data and methods 1.1, general information 120 cases are my anorectal department hospitalized mixed hemorrhoid patients, male 63 cases, female 57 cases; age 19 ~ 71 years old, medical history 2 ~ 20 years. They were randomly divided into 60 cases in the treatment group, 31 male and 29 female; and 60 cases in the control group, 32 male and 28 female, according to the order of diagnosis, and were subjected to external stripping and internal ligation of mixed hemorrhoids. 1.2 Methods Starting from the 1st day after operation, the treatment group used anal fumigation instrument to apply hemorrhoidal fumigation formula (hansansanqi 30g baiqiuqi 20g lianlian 30g bitter ginseng 60g) to fumigate sitz bath, hemorrhoidal fumigation formula is 1 dose per day, decocted with water twice, and a total of 2,000 ml of juice is extracted, divided into morning and evening for 2 times, 1,000 ml for each time, the temperature of the liquid is set to be between 37-40 ℃, and the liquid is firstly atomized for 3min, then The temperature of the liquid was set between 37-40℃, and the liquid was first atomized for 3min, and then rinsed for 20min and 30min, and the water column was aligned with the wound as much as possible when rinsing. Control group with anal fumigation instrument application Jin Xuan hemorrhoids fumigation powder bag, dissolved in 1000ml warm water fumigation sitz bath, 2 times a day, the liquid temperature is set to 37-40 ℃, according to the prescribed operation of the first nebulization 3min. then rinse 20 min 30 min, rinsing as much as possible to make the column of water aligned with the wound. After fumigation ( sitz bath ), our homemade decorticating muscle cream wound dressing, 2 times / day, 2 groups are routine postoperative anti-infection treatment for 6 days. 1.3 Observation indexes Observe the degree of anal margin edema, anal pain, and blood in stool on the 1st, 4th, and 8th postoperative days of the 2 groups and score them (take the image data for observation). Clinical observation index scores: anal margin edema: 0 degree: no edema (0 points); 1 degree: edema diameter <1 cm (2 points); 2 degrees: edema diameter 1-2 cm (4 points); 3 degrees: edema diameter >2 cm (6 points). Anal pain – the degree of pain is divided into 4 grades: Grade 0: no pain (0 points); Grade 1: mild pain, can be tolerated, do not have to deal with (2 points); Grade 2: pain is obvious, affecting sleep, requiring oral painkillers can be relieved (4 points); Grade 3: pain is severe, seriously affecting sleep, analgesic treatment is required, the effect is not obvious (6 points). Blood in stool: no bleeding (0 points); mild: bleeding, blood visible on hand paper (2 points); moderate: blood dripping after stool (4 points); severe: jet bleeding (6 points). 1.4, Statistical analysis Statistical analysis was carried out using SPSS 16.0 software. edema, pain, blood in stool were grade count data, expressed as rate (%), and the difference between groups was compared using the rank-sum test. p<0.05< font=""> was taken as the difference was statistically significant. 2.1 Comparison of edema scores of the two groups at different times The analysis results are shown in the table below, before medication, the difference between the edema scores of the treatment group and the control group was not obvious and not statistically significant (P>0.05); when the medication was administered for 3 days and 7 days, the difference between the edema scores of the treatment group and the control group was obvious and statistically significant (P<0.05)< font="">, and the therapeutic efficacy of the treatment group was better than that of the control group. 2.2 Comparison of pain scores of the two groups at different times From the results of data analysis, it can be seen that the difference between the pain scores of the treatment group and the control group was not obvious and not statistically significant (P>0.05) before the administration of the drug; the difference between the pain scores of the treatment group and the control group was obvious and statistically significant (P<0.05)< font=""> on the third and seventh days of the drug, the efficacy of the treatment group was better than that of the control group. 2.3 Comparison of blood in stool scores between two groups at different times Analyzing results: the difference in blood in stool scores between the treatment group and the control group was not significant before the medication, 3 days after the medication, and 7 days after the medication, all of them were not statistically significant (P>0.05). 3, Discussion Lavage therapy is an important external treatment method for traditional treatment of anorectal diseases, which is called washing method in Surgery of Traditional Chinese Medicine, anciently known as thirst ulceration method, and is one of the valuable heritage of the motherland medicine, which has been applied in China for thousands of years. Fumigation is a therapeutic method that utilizes medicines and water to be boiled in a decoction, and then fumigated and washed on the skin or affected area while it is still hot. Chinese medicine fumigation as a unique method of treatment of anal and intestinal diseases, first smoked and then washed, physiotherapy, pharmacotherapy two-pronged, both treatment and prevention, treatment and prevention of dual efficacy, the drug directly on the site of anal and intestinal diseases, through the heat and the role of drugs, so that the capillary dilatation, promote blood circulation and metabolism, reduces the release of vasoactive substances, reduces the excitability of the nerves, muscle tone and permeability of blood vessels. Recent pharmacological studies have shown that local fumigation with Chinese medicine has a good anti-infective effect and promotes cell division and granulation tissue growth, accelerating wound healing to a certain extent. Traditional Chinese medicine believes that after the operation of anorectal disease, damp-heat infiltration blocks the anus, stagnation of qi and blood, meridian blockage, coupled with local inflammation and edema, the anal pain is intense. Damp-heat injection, heat injury to the veins, blood spillage outside the veins, then the wound oozing blood. Dampness and heat inside, condensation in the skin between the coupling, gas and blood running not smooth, essence and micro not cloth, then the long time not close the mouth. Our own hemorrhoidal washing formula (including: Han Panax notoginseng 30g Bai Qucai 20g Bitter ginseng 60g Huanglian 30g) is used for postoperative washing of mixed hemorrhoids in order to alleviate the patient’s pain, bleeding, tissue edema and other complications. In the formula, Panax notoginseng is known as “the miracle medicine for stopping bleeding”, dispersing blood stasis and stopping bleeding, eliminating swelling and pain as the monarch’s medicine; Radix et Rhizoma Cyperiopsis promotes qi and stops pain, induces diuresis to eliminate swelling, assisting the monarch’s medicine in eliminating blood stasis and stopping bleeding, promoting qi, inducing diuresis to eliminate swelling, and as the minister’s medicine, the stasis and blood is dispersed, blood returns to the meridians, qi flows through the channels and passes through the channels, and then it is not painful; Bitter ginseng and Huanglian are cold and bitter, and return to the large intestine meridian, which not only clears dampness and heat of the large intestine but also diarrhoeal to the wound. Clearing heat, drying dampness and relieving itching are the same as adjuvant drugs. Modern pharmacological research has proved that: bitter ginseng can be anti-inflammatory, antibacterial, dysentery bacillus, staphylococcus aureus, Salmonella vidarius have significant inhibitory effect. The combination of all the medicines together play the efficacy of removing blood stasis and stopping bleeding, reducing swelling and pain, clearing heat and drying dampness, so it can make the local blood flow, reduce pain and accelerate wound healing. In summary, hemorrhoidal wash formula can treat the postoperative mixed hemorrhoids patients with local granulation tissue edema, wound pain, bleeding during defecation and other complications, and in reducing edema, relieving pain than Jinxuan Hemorrhoidal Fumigation San the effect is more pronounced, the application of safe, efficacious, convenient, worth promoting. Application of anal and intestinal fumigation instrument fumigation treatment during hospitalization is more convenient and hygienic than fumigation by oneself, and the use of decocted traditional Chinese medicine is less damaging to the machine, whereas the bulk of the medicine, due to the incomplete dissolution, will often cause the machine to be blocked, and must be cleaned in a timely manner. However, the use of traditional Chinese medicine needs to go through the process of decoction, carrying up Jinxuan Hemorrhoidal Fumigation is not very convenient, this point is precisely the need to continue to improve the learning place.