Traditional Chinese Medicine in the Adjuvant Treatment for Pain With Hemorrhoidectomy: A Systematic Review and Network Meta‐Analysis

This study systematically evaluated the clinical efficacy of traditional Chinese medicine (TCM) external therapies as adjuvant treatments for pain following hemorrhoidectomy, using a network meta‐analysis of randomized controlled trials (RCTs). Systematic searches were conducted in PubMed, the Cochrane Library, Embase, CNKI, SinoMed, and Wanfang databases. Seven types of TCM external therapies were included, such as acupuncture, herbal fumigation, and others. The visual analog scale (VAS) was selected as the primary outcome measure for pain assessment. We included RCTs that compared predefined TCM external therapies—acupuncture, auricular point therapy, herbal fumigation, catgut implantation at acupoints, wrist–ankle acupuncture, and moxibustion—with placebo treatments (e.g., sham acupuncture or blank control) or western medications limited to nonsteroidal anti‐inflammatory drugs (NSAIDs) (mainly included indomethacin, ibuprofen, celecoxib, dezocine, and lidocaine) and opioid analgesics. Auricular point therapy significantly reduced pain within 3–8 h posthemorrhoidectomy, as indicated by the surface under the cumulative ranking curve (SUCRA). Wrist–ankle acupuncture ranked first at 24 h (SUCRA = 0.796), floating needle therapy at 48 h (SUCRA = 0.997), catgut implantation at Day 3 (SUCRA = 0.878), and herbal fumigation at Day 5 (SUCRA = 0.783). TCM external therapies effectively alleviate posthemorrhoidectomy pain. Different therapies may provide optimal analgesia at various postoperative time points. A multimodal analgesic approach incorporating TCM may offer a promising strategy for alleviating hemorrhoidectomy‐related pain.