Hemorrhoids were one of the first diseases recorded in Chinese medicine. It once included most anorectal diseases, such as documented hemorrhoids (anal fistula), hooked hemorrhoids (anal fissure), polyp hemorrhoids (rectal polyps), and locked hemorrhoids (anorectal cancer). The current medical term for a single disease is divided into internal, external, and mixed hemorrhoids. Internal hemorrhoids are pathological changes or abnormal displacement of the supporting structures of the anal cushion, vascular plexus and arteriovenous anastomotic branches. External hemorrhoids are pathological dilatation and thrombosis of the subepidermal venous plexus distal to the dentate line of the inferior rectal vein. Mixed hemorrhoids are the fusion of internal hemorrhoids through the rich venous plexus anastomosis and the corresponding parts of the external hemorrhoid plexus. Hemorrhoids are a common and frequent clinical condition, and it is said that “nine out of ten people have hemorrhoids”. This disease occurs in adults over 20 years of age, but rarely in children. Treatment: Cool the blood, clear heat and dispel wind. Remedy: Cool the Blood, add reduction to Dihuang Tang. Damp-Heat Infusion Syndrome: Dull stomach, constipation, red urine, dampness and swelling in the anus, bright-colored blood in stool, large amount, pale tongue, yellowish fur, string veins. Treatment: Clearing heat and relieving dampness to stop bleeding. Remedy: Doulian Wan plus or minus. Qi stagnation and blood stasis type Symptoms: pain and swelling in the anal region, swelling, swelling with prolapse of swelling, thrombosis may occur, dark red tongue, thin coating, string pulse. Treatment: Promote blood circulation, eliminate blood stasis, relieve swelling and pain. 2, external treatment (1) fumigation method: the drug according to the formula decoction fumigation sitz bath, in order to play its clear heat and dampness, dispel wind and relieve itching, resolve blood stasis and relieve pain. The formula used is San Cao lotion or Nitro Yellow lotion; Huang Lian detoxification soup, etc. (2) External application of Chinese herbal medicine: apply the medicine to the affected area of the anus according to the formula, so as to clear heat and detoxify, invigorate blood circulation, relieve blood stasis, reduce swelling and pain, astringent and stop bleeding, and remove decay and create muscle. However, according to the different diseases, we should choose the right creams, such as Huanglian cream, Jiuhua cream, Anal Tai cream, etc. (3) plugging method: into the anal suppositories into the medicine, play its heat detoxification, blood circulation and blood stasis, reduce swelling and pain, astringent and hemostatic function. Such as the hemorrhoid suppositories, anal plugs, Jiuhua hemorrhoid suppositories, Ma Yinglong hemorrhoid suppositories, Tai Ning suppositories, etc. (4) Western ointments: such as erythromycin ointment, tetracycline ointment, etc., with anti-inflammatory and antibacterial effects. Hemostatic agents: such as gelatin sponge, thrombin, etc. Analgesics: such as compound tannic acid ointment, with the function of decongesting and astringent pain relief. Enzymes: such as а-chymotrypsin, which can break down necrotic tissue and promote wound healing. Other therapies There are two types of hemorrhoid therapies: hemorrhoid dispersion therapy and hemorrhoid nail therapy. The former is to apply hemorrhoid dispersion and grey soap dispersion to the surface of prolapsed internal hemorrhoid nucleus, using the strong corrosive effect of drugs to make the nucleus necrotic and wither away to achieve the purpose of curing the disease. Because of its toxic side effects, it is rarely used nowadays. The hemorrhoid nail therapy is to insert the drug into the hemorrhoid nucleus in a certain order to make the nucleus produce a sterile inflammatory reaction, fibrous tissue hyperplasia or dry necrosis to achieve the purpose of treatment. Because of its toxic side effects, it is also less used clinically at present. Injection therapy Indications: First, second and third stage internal hemorrhoids, internal hemorrhoids with anaemia, internal part of mixed hemorrhoids. Contraindications: External hemorrhoids, internal hemorrhoids with acute and chronic perianal inflammation, diarrhea, or patients with serious blood diseases, heart, liver, lung, kidney and other organ diseases, abdominal tumors. The patient must be pregnant before delivery. Commonly used drugs 5% sodium cod liver oil acid, 4%-6% alum liquid, 5%-10% glycerin carbonate, antihemorrhoid spirit, etc. Methods Sclerosing atrophy injection method patient in lateral position, routine surgical area disinfection, placement of anoscope, revealing the internal hemorrhoid area, iodophor disinfection. The 5ml syringe (No. 5 needle) is used to extract 5% glycerol carbolic acid or 4%-6% alum liquid on the dentate line 0.5ml of the hemorrhoid nucleus into the submucosa, each hemorrhoid nucleus is injected 0.3-0.5ml, generally 3 hemorrhoids are injected each time. After the operation, the stool should be controlled for 24 hours, and bed rest should be given on the same day, depending on the sclerosis and atrophy of the hemorrhoid nucleus, the injection can be given again after 7 days. Note: The liquid must be injected in the submucosa, too shallow is prone to mucosal ulceration; too deep will cause sclerosis of the muscular layer. The injection method of hemorrhoid elimination is generally divided into 4 steps. The first step of injection: the upper area of internal hemorrhoids (i.e. the supra-arterial area of hemorrhoids) is about 2-4 ml. The second and third step of injection: the submucosa and the intramucosa of hemorrhoids are injected. The total amount is about 30-50ml. Injection points: 1. The injection solution should be staggered up and down, avoiding the same plane, otherwise it is easy to appear circular scar and cause narrowing of the intestinal cavity. 2. 2, the distribution of the drug should be uniform, after the needle can be rotated, while retreating the needle injection, after the completion of injection can be gently massage the injection area. Concentration of the drug in one area is prone to hard nodules and necrosis. 3, the injection depth should be appropriate, too deep into the muscle layer or too shallow injection in the mucosal surface layer, are prone to cause necrosis or sclerosis. Precautions: 1. The injection area must be strictly disinfected, and the operation should be performed after each injection. Do not stab multiple parties after entering the needle, so as not to damage the blood vessels and cause bleeding, resulting in swelling of the hemorrhoid nucleus and affecting the efficacy. 2.Do not inject the medicine into the external hemorrhoid area, causing painful perianal edema. 3.Inject the small hemorrhoid nucleus first so that the small nucleus is not covered by the large one, affecting the operation or causing omission. If the internal hemorrhoid comes out during the operation, it must be returned to the patient in time to avoid the occurrence of embedded edema and pain. Ligation therapy 1.Through ligation method Indications: Second and third stage internal hemorrhoids. Contraindications: those with acute and chronic inflammation around the anus; those with dysentery or diarrheal diseases; those with serious heart, lung, liver, kidney, or blood diseases; pregnant women in labor. Preoperative preparation: routine enema, skin preparation, left lateral position or lithotomy position, routine disinfection of the operative area, and laying of towel sheets. The procedure: local anesthesia or sacral anesthesia, disinfect the anal canal and lower rectum, reveal the internal hemorrhoid with anal sphincter, clamp the base of the internal hemorrhoid nucleus with hemorrhoid clamp, cut a small V-shaped mouth at the tooth line of the lower end of the hemorrhoid with scissors, ligate the internal hemorrhoid with 8 sutures around the clamp, remove the stump and send the ligated hemorrhoid nucleus back to the anus and apply yellow lily oil sand or comfrey oil sand strips, fix it with gauze outside. Note: It is advisable to tie the small hemorrhoid nucleus first and the large hemorrhoid nucleus later; do not tie the hemorrhoid nucleus on the same plane to avoid postoperative intestinal stenosis; control the stool for 24 hours after surgery, if the hemorrhoid comes out after the stool, it must be returned in time to avoid painful entrapment edema. Hemorrhoid shedding generally takes 5-12 days, during this period to reduce activity, prevent constipation or diarrhea, to prevent postoperative hemorrhage. 2.Glue ring ligature method Indications: Second and third stage internal hemorrhoids, internal hemorrhoids part of mixed hemorrhoids. Contraindications: the same as penetration therapy. Surgical method The ligature ligation method preoperative preparation is the same as the penetration ligation method, general local anesthesia is the main, set the anoscope, routine disinfection of the hemorrhoid area, the ligature ligature set the root of the internal hemorrhoid nucleus, the rubber ring set in the base of the hemorrhoid nucleus, postoperative treatment is the same as the penetration ligation method. Double-clamp ligation method is the same as the penetrating ligation method, local anesthesia, reveal the internal hemorrhoid nucleus, disinfect the anal canal and the hemorrhoid area. Clamp the base of the internal hemorrhoid with a hemorrhoid clamp with a rubber band, and use another curved clamp to hold the other side of the rubber band to stretch it over the base of the hemorrhoid, then relax and remove the vascular clamp. The postoperative treatment is the same as the penetrating ligation method.