Xiaozhiling () four-step injection in treating hemorrhoids of stages III and IV — a sclerotherapeutic approach of thrombosing branches of Artery Rectalis Superiorfour-step injection in treating hemorrhoids of stages III and IV — a sclerotherapeutic approach of thrombosing branches of Artery Rectalis Superior

Objectice: Traditional Chinese medicine has a long history of over 2,000 years in treating piles, based on the principle “Sore herbs can be stringent while the puckery can control prolapse”, and a large amount of precious experience has been accumulated.Methods: Prepared mainly with such effective compositions as gallnut (Galla Chinensis) and alum, Xiaozhiling (XZL) was applied in treating piles of stages III and IV. Fourstep injections were given at (1) the branches of artery rectalis superior (ARS), (2) the submucosa, (3) the mucous lamina propria, and (4) the sinous veins. The injection obliterated the ARS and made piles sclerosed, atrophied and finally disappear.Results: From 1987 to 1996, piles of stages III and IV were treated of 21,361 cases. Of all the cases, 21,148 (99%) were cured, 203 (0.95%) improved and 10 (0.05%) ineffective for whom surgery was used. Of the 620 cases who were followed up 3 years after treatment, it recurred in only 6 cases (prolapse, 1 %).Conclusion: This method summarized a relatively ideal non-operative approach in the treatment of piles of stages III and IV.