Objective

2

To observe the short-term and long-term efficacy of traditional Chinese medicine （TCM） surgical operations in treating mixed hemorrhoids.

Methods

2

A multi-center retrospective cohort study was conducted， collecting clinical data from 17，831 mixed hemorrhoid surgery patients in 8 top-tier TCM hospitals in Jiangsu Province. Standardized and structured datasets were obtained through artificial intelligence models. Patients who underwent western surgical treatment were categorized into the western surgery group （11

646 cases）， and those receiving TCM surgical operations were categorized into the TCM surgery group （6185 cases）. Propensity score matching （1∶1 matching） was used to balance baseline data between groups. The primary outcome was the one-year recurrence rate， and secondary outcomes included the main symptoms （rectal bleeding， degree of prolapse） and secondary symptoms （anal distension， anal edema， wound secretion and exudation， anal stenosis， residual skin tags， perianal itching， and anal pain） measured on days 7， 28， and 60 after discharge.

Results

2

After matching， 2194 patients were included in each group. Symptom scores showed that at 28 days after discharge， th

e TCM surgical group had superior improvement in rectal bleeding ［

OR

=5.786， 95%

CI

（3.092，10.827）］， degree of prolapse ［

OR

=4.510， 95%

CI

（1.649，12.333）］， and anal edema ［

OR

=3.188， 95%

CI

（1.295，7.845）］ compared to the western surgical group. At 60 days post-discharge， the TCM group still showed advantages in improving rectal bleeding ［

OR

=5.237， 95%

CI

（1.077，25.464）］ and anal pain ［

OR

=11.697， 95%

CI

（1.186，115.336）］ （

P

＜0.05）. Long-term follow-up showed that the one-year recurrence rate in the TCM surgery group was 1.1% （8/726）， while that in the western surgery group was 2.3% （10/444）， with no statistically significant difference between the two groups （

P

＞0.05）.

Conclusion

2

Based on real-world data， TCM surgical treatment for mixed hemorrhoids shows significant short-term symptom improvement， particularly in terms of hemostasis， reducing swelling， and alleviating prolapse of anal masses.