Objective:To observe the clinical efficacy of Zhixuean Mixture in treating hemorrhoids bleeding in elderly patients of damp-heat pouring downward syndrome. Methods 120 elderly patients with hemorrhoids bleeding were randomly divided into the treatment group and control group,60 cases in each group. The treatment group was orally treated with Zhixuean Mixture,the control group was orally treated with Huaijiao Pills,with a course of 2 weeks. The changes of hematochezia, bearing-down pain, hemorrhoids mucosa, hemorrhoidal node size and prolapse in both groups were observed before and after treatment and follow-up for 2 weeks.  Results: After treatment,the integrals of hematochezia, bearing-down pain, hemorrhoids mucosa and hemorrhoidal node size were decreased in both groups compared with treatment before(P<0.05,P<0.01),and the integrals of hematochezia, hemorrhoids mucosa and hemorrhoidal node size in the treatment group were lower than those in the control group(P<0.05).When followed-up for 2 weeks,the integrals of hematochezia, bearing-down pain, hemorrhoids mucosa and hemorrhoidal node size were significantly decreased in both groups compared with treatment before and after(P<0.05),and the integrals of hematochezia and hemorrhoids mucosa in the treatment group were lower than those in the control group(P<0.05).  Conclusion: Zhixuean Mixture shows good effects in the treatment of hemorrhoids bleeding in elderly patients.