Background: Hemorrhoids are one of the most common conditions that lead to surgery,and until now surgical hemorrhoidectomy has been the major effective treatment.Post-operative pain from hemorrhoidectomy has been experienced by thousands of patients and remains a major inconvenience of the operation.Objective: This study evaluates the clinical efficacy of the pestle needle therapy,an acupoint stimulation method,for relief of post-hemorrhoidectomy pain.Design,setting,participants and interventions: This was a single-center,patient-assessor-blinded and randomized controlled trial with 154 patients receiving Milligan hemorrhoidectomy surgery.Eligible patients were randomly assigned to either a treatment group or a control group at a ratio of 1∶1.The treatment group received the pestle needle therapy,with manual stimulation at Yaoshu (DU2),Mingmen (DU4),Changqiang (DU1),Chengshan (BL57),Erbai (EX-UE2) and the perianal points (1,3,5,7,9,and 11o'clock around the lesion);while the control group received a sham treatment with very light pressure.Three sessions of treatment were performed at 30 min,4 h and 12 h after the surgery,and each lasted for 15 min.Main outcome measures: The primary outcome was post-operative pain measured with the visual analogue scale (VAS) at 12 h after surgery.The secondary outcomes included the VAS scores measured at 0.5,2,4,6,8,24 and 48 h after surgery,the analgesic dose,the time and the VAS score of the patients' first defecation after surgery,as well as the Hamilton Rating Scale for Anxiety (HAMA) evaluated before discharge.Results: The mean pain score of the treatment group was significantly lower than that of the control group (3.10 ± 1.27 vs 4.82 ± 1.29;P ＜ 0.001) at 12 h after surgery.Compared with the control group,patients in the treatment group needed a smaller dose of analgesic within the first 24 hours after surgery (P =0.002);and their HAMA scores before discharge were lower (4.07 ± 2.40 vs 5.10 ± 2.45,P-0.009).Compared to the treatment group,patients in the control group had a greater time to the first defecation after surgery ([52.34 ± 15.72]h vs[27.08 ± 13.68]h;P ＜ 0.001),but there was no difference in their VAS scores at the first defecation (P =0.092).Conclusion: The pestle needle therapy was effective for relieving pain,reducing anxiety and improving bowel function after hemorrhoidectomy,and it is worthy of clinical application.