Chinese peony (Paeonia lactiflora) root has a long history of use in Traditional Chinese Medicine (TCM), often as part of complex herbal formulas. In the context of hemorrhoids, Chinese peony is commonly included in formulations like "Hua Zhi Wan" or other anti-hemorrhoidal preparations. The traditional rationale is based on its reputed ability to "nourish the blood," "dispel wind," and "alleviate pain." Peony is also thought to have mild anti-inflammatory and analgesic effects according to TCM theory, which may contribute to symptom relief in hemorrhoidal disease such as swelling, pain, and bleeding.

However, direct scientific evidence supporting the use of Chinese peony specifically for hemorrhoids is limited. Most available studies focus on its effects within multi-herb formulas, making it difficult to attribute efficacy solely to peony root. Some modern pharmacological research has identified anti-inflammatory, vasodilatory, and analgesic properties in peony root extracts, which could plausibly provide symptomatic relief for hemorrhoids, but these effects have largely been demonstrated in animal models or in vitro studies, not in clinical trials for hemorrhoids.

In summary, the use of Chinese peony for hemorrhoids is primarily justified by traditional use and historical formulations, with only limited indirect scientific support. There is a lack of robust clinical evidence directly validating its effectiveness for this specific condition.