Objective  To explore the clinical efficacy of Ruyi Jinhuang Powder combined with midnight-noon ebb-flow acupuncture in the management of postoperative complications of mixed hemorrhoids.

Methods A total of 90 patients who underwent external dissection and internal ligation in the Department of Hepatobiliary and General Surgery, Anhui Provincial Corps Hospital of Chinese People’s Armed Police Force, from March, 2024 to April, 2025 were enrolled. These patients were randomly divided into three groups: the control group, the traditional Chinese medicine (TCM) external application group, and the combined treatment group, with 30 cases in each group. The control group was disinfected with 0.5% metronidazole solution after potassium permanganate sitz bath. The TCM external application group received additional external application of Ruyi Jinhuang Powder on the basis of the control group’s treatment. The combined treatment group was further given midnight-noon ebb-flow acupuncture on the basis of the TCM external application group’s treatment. All three groups received continuous treatment for 14 days. Clinical efficacy, Visual Analogue Scale (VAS) score, pain mediator (5-hydroxytryptamine, 5-HT) level, wound area, wound healing time, wound area reduction rate, edema score, levels of inflammatory factors (high-sensitivity C-reactive protein, hs-CRP; tumor necrosis factor-α, TNF-α; interleukin-6, IL-6), levels of angiogenic factors (vascular endothelial growth factor, VEGF; platelet-derived growth factor, PDGF), and TCM syndrome score were compared among the three groups.

Results On the 14th day after surgery, the total effective rate of the combined treatment group (96.7%) was significantly higher than that of the control group (53.3%) and the TCM external application group (70.0%). Compared with the control group and the TCM external application group, the combined treatment group showed significantly better VAS score, 5-HT level, wound area, wound area reduction rate, wound healing time, edema score, TCM syndrome score, levels of inflammatory factors, and levels of angiogenic factors (all P ＜ 0.05).

Conclusion Ruyi Jinhuang Powder combined with midnight-noon ebb-flow acupuncture can effectively inhibit excessive postoperative inflammatory response, promote wound healing, and alleviate postoperative complications such as pain and anal edema.