Compound Huangbai Liquid was originally a Chinese medicinal liquid for the treatment of sores and ulcers after Yang evidence, and based on its drug composition and properties, the authors concluded that it could be applied in anorectal medicine. In order to observe the clinical effect, 130 patients with anorectal diseases and some post-surgical patients were clinically observed from October 2007 to April 2008. 1. Data and methods 1.1 General data 130 patients, gender: 86 males and 34 females; age 18-72 years old, average 42 years old. 45 post-surgical cases were from the seven wards of the Department of Proctology, and the other 75 cases were from outpatients. Distribution of disease types: 15 cases of unoperated hemorrhoids, 15 cases after surgery; 20 cases of unoperated anal fistulas, 20 cases after surgery; 10 cases of unoperated anal fissures, 10 cases after surgery; 10 cases of perianal eczema, including 2 cases of eczema around the left lower abdominal stoma; 10 cases of anal pruritus; 10 cases of ulcerative colitis and 10 cases of radioactive proctitis. Disease diagnosis was made according to the “Industry Standard of Traditional Chinese Medicine of the People’s Republic of China. Diagnostic Efficacy Criteria for TCM Diseases”. 1.2 Inclusion criteria All patients with anorectal diseases who visited our department and had no history of allergy to the drugs contained in the compound and agreed to use the drug were enrolled. If any adverse reaction is found during the treatment, the drug will be stopped immediately and treated symptomatically, or other drugs will be used instead. 1.3 Observation method 1.3.1 Drug: compound Huangbao liquid, provided by Shandong Hanfang Pharmaceutical Co., Ltd, (outside) State Drug Quotient Z10950097, Patent No. ZL96106739, International Patent Master Sub-Number: A61K 35/78, Lot No. 0705146, 0705222, 0708152, 0804141. 1.3.2 Usage: For all patients with non-operated anal disease, including hemorrhoids, anal fistula, anal fissure, perianal eczema (including 2 cases of eczema around the left lower abdominal stoma), and anal itching, wet compress the affected area with sterile skimmed cotton balls dipped in the original drug solution twice daily for 7 days. In patients with post-surgical anal disease, including post-external stripping and internal ligation of mixed hemorrhoids, post-anal fistula incision, post-high anal fistula incision and hanging, and posterior sphincter partial incision of anal fissure, the wounds were moistened with strips of cotton paper dipped in the drug provided by the manufacturer until the wounds healed. For ulcerative colitis and radiation proctitis, enemas were reserved with 100 ml of physiological saline solution according to 1:1 compound cypress solution once a day for 7 days. 1.3.3 Symptoms before and after treatment scoring criteria Clinical observation of anal pain, pruritus, edema, blood in stool (pus), and wound healing time were observed according to the common characteristic symptoms of anal diseases. The grade score criteria of each symptom are as follows. Table 1 Clinical symptom rating scale Clinical symptoms 0 points 1 point 2 points 3 points Pain no tolerable intolerable pain medication required Restricted movement Itching no tolerable Intermittent episodes requiring medication with obvious skin lesions Edema no 2cm3 Blood in stool (pus) no Blood on hand paper Dripping blood/mucus stool Spraying blood/pus in stool Cure: disappearance of symptoms and signs. Improvement: Improvement of symptoms and signs. Not cured: no improvement of symptoms and signs, or the patient gave up the medication. 3. Results 3.1 Efficacy records The purpose of the efficacy records is to observe the duration of action of the compound Phellodendron liquid on the clinical symptoms and signs of anal diseases, and to guide and improve the method and manner of clinical medication. As can be seen from Table 2, the improvement of anal pain was early, mostly on the 1st~3rd day, anal itching on the 2nd~3rd day, anal edge edema on the 3rd day, and blood in stool on the 3rd~4th day. Table 2 Recorded time of onset of effect within one week Symptoms (number of cases) After treatment (number of cases) 1 2 3 4 5 6 7 Pain (75) 12 30 26 2 0 0 0 0 Itching (98) 3 12 35 22 3 3 1 Edema (42) 0 3 33 2 1 1 0 Blood in stool (pus) (36) 1 2 15 14 0 0 2 3.2 Recorded time of wound healing The purpose of recording the time of wound healing is to reflect whether the compound Huangbai liquid can Table 3 shows that the healing time of mixed hemorrhoids and posterior sphincter partial dissection of anal fissure was more than 21 days, and the healing time of anal fistula dissection was more than 28 days, and the healing time of two cases of high anal fistula dissection and suturing was more than 28 days. Table 3 Record of wound healing time -14d -21d -28d >28d Mixed hemorrhoids with external stripping and internal ligation (15) 3 10 2 0 Fistulotomy (16) 2 6 5 3 High anal fistula with incision and hanging wire (4) 0 1 1 2 Posterior sphincter partial incision of anal fissure (10) 1 6 3 0 3.3 Record of adverse reactions and abandonment of medication The purpose of the record of adverse reactions and abandonment of medication is to observe the effect of compound The purpose of the adverse reactions and abandonment of treatment records was to observe the adverse effects of Phellodendron solution on the affected area and surrounding skin and the patients’ perception of the drug. There were 4 cases of skin adverse reactions in this group and the drug was stopped immediately. In 18 cases, the efficacy of the drug was considered unsatisfactory and the patients gave up the drug automatically. Table 4 Adverse reactions and abandonment of medication treatment Table Perianal tingling 2 Perianal skin papules 2 Abandonment of medication 18 3.4 Comparison of symptom scores before and after treatment The comparison of symptom scores reflected the significant efficacy of compound cypress liquid in improving the main anal symptoms and signs (P<0.01). Table 5 Comparison of symptom scores before and after treatment Before treatment After treatment Pain 2.4±0.5 0.5±0.3 Itching 1.8±1.1 0.25±0.2 Edema 2.7±1.1 0.3±0.2 Stool (pus) blood 2.8±1.2 0.72±1.2 3.5 Treatment effect The effect was observed after 6 months of follow-up, as shown in the following table. Table 6 Treatment effect Cured Improved Not cured Hemorrhoids 15 2 11 2 Anal fistula 20 0 16 4 Anal fissure 10 6 3 1 Perianal eczema 10 4 2 4 Anal itching 10 3 2 5 Mixed hemorrhoids after external peeling and internal ligation 15 15 0 0 0 Anal fistula after incision and hanging 16 16 0 0 0 High anal fistula after incision and hanging 4 3 1 0 Anal fissure after posterior sphincter partial incision 10 8 2 0 Ulcerative colitis 10 3 5 2 Radiation proctitis 10 2 4 4 4. Discussion The main drug composition of compound Huangbai liquid is forsythia, Huangbai, honeysuckle, dandelion and centipede. It has the efficacy of clearing heat and detoxification, eliminating swelling and eliminating decay. The pharmacological effects include anti-Gram-positive bacteria, anti-inflammatory and promoting wound healing, and also enhancing the phagocytosis of mononuclear giant cells and improving the effect of non-specific immunity. The original drug is a red-brown liquid, which can be applied externally to wounds or deep ulcers for flushing, with a general dosage of 10~20 ml. It is suitable for ulcerated sores and osteomyelitis, bone tuberculosis sinus tract, vasculitis and other difficult diseases and common diseases such as traumatic infections after ulceration of sores and ulcers, and is a potent medicine for clinical septic infections. It is known as the holy medicine for sores, and is used in the "Divine Husbandman's Classic of the Materia Medica", "for cold and fever, scrofula, scrofula, carbuncles and malignant sores, gall tumors, and knotted fever." Honeysuckle, cold in nature, sweet in taste and flat in air, has the ability to clear heat and detoxify the body, which can treat heat and swelling, carbuncles and furuncles. Pharmacology confirmed that honeysuckle contains cyclohexanol, flavonoids, inositol, saponins and tannin, its water and wine infusion has a broad-spectrum antibacterial effect, on Staphylococcus aureus, dysentery bacillus and other pathogenic bacteria have a strong inhibitory effect, on leptospira, influenza virus and pathogenic mold and other pathogenic microorganisms also have inhibitory effect. Flavonoids as the main component of the drug has been widely used in clinical practice. Yinhua and forsythia both have good effect of clearing heat and detoxifying, which can not only penetrate heat to reach the surface, but also clear internal heat and detoxify sores, so the two drugs are often used together in clinical practice. Huang Bai has a long history of application in anorectal diseases, the treatment of perianal eczema has been proven. The "endangered lake set brief formula" to treat carbuncles and swelling poison with Phellodendron Bark (fried), Chuan Wu head (cannon), etc., for the untuned coated, leaving the head, frequent wet with rice bath slop; "fill the lack of elbow after the formula" to treat men's Yin sores damage with Phellodendron Bark boiled water wash, or with Huang Lian, Phellodendron Bark, etc. into the powder of the end; "the secret record of the mother" to treat children's umbilical sores do not fit with the Phellodendron Bark end coated; "simple single prescription" to treat children's abscesses, not dry all over the body with Phellodendron Bark end with a little orange alum mixed with it. Experiments have proved that dandelion on Staphylococcus aureus, hemolytic streptococcus, pneumonia, meningococcus, diphtheria streptococcus, Pseudomonas aeruginosa, dysentery bacillus, typhoid bacillus, katococcus, etc., have a killing effect, tuberculosis bacillus, some fungi and viruses also have a certain inhibitory effect. Therefore, to a certain extent, it can be used instead of antibiotics. Centipede in the "Medical Compendium" cloud "to treat children's convulsions and wind convulsions, umbilical wind mouth silence, dancers, bald sores, scrofula, stool poisoning, hemorrhoids, snakebite." For example, it is used in "Jisheng Secrets" for treating the initial onset of stool poisoning, and in "Renzai Zhizhi Fang" and "Sun Tianren Jihui Fang" for treating painful hemorrhoids. The preliminary clinical observation results show that compound Huangbai Liquid can significantly improve the symptoms of anorectal diseases and some anal diseases after surgery, such as pain, itching, edema and pus and blood in stool, etc. It is ideal for the treatment of hemorrhoids, anal fistula, ulcerative colorectitis and after external peeling and internal ligation of hemorrhoids and anal fistula incision, and it also has better effect on other anorectal diseases. According to its drug composition and preparation process, there are no ethical barriers or contraindications to its use when applied to anorectal diseases. In order to expand the scope of its clinical application, the authors conducted preliminary clinical observation on common anorectal diseases and felt that the effect was satisfactory, with the effect of anti-infection, anti-ulcer, promoting tissue repair and wound healing, and its preparation is easy to apply, with fast onset time and significant efficacy, so the authors believe that compound Huangbai liquid can be used externally for anorectal diseases and postoperative.