Objective To investigate the effect of operation combined with Decoction for Tonifying Qi, Invigorating Spleen and Relaxing Bowel in the treatment of female patients with outlet obstruction constipation caused by rectocele.Methods Eighty female patients with outlet obstruction constipation caused by rectocele were randomly divided into control group (n = 40) and observation group (n = 40). Both groups were treated with transvaginal repair and the eastern rubber band ligation and coincide of dislocation for prolapse and hemorrhoid (EPH). The observation group was additionally treated with self-made Decoction for Tonifying Qi, Invigorating Spleen and Relaxing Bowel from 2 days after operation, with 14 days as a course of treatment. After 2 courses of treatment, the therapeutic effect was evaluated, and the occurrence of adverse reactions was recorded.Results The differences of scores in the defecation frequency, degree of difficulty in defecation, stool characteristics, defecation time, feeling of incomplete defecation, dizziness, fatigue, dry mouth and thirst before and after the treatment of the observation group were higher than those of the control group (P < 0.05). After treatment, the clinical effective rate of the observation group was higher than that of the control group (95.00% VS 80.00%, P < 0.05). There was no significant difference in the incidence of abdominal distension or diarrhea, nausea or vomiting, bleeding, pain, urinary retention and the overall rate of adverse reactions between the two groups (P > 0.05), and all the adverse reactions were mild and no severe adverse reactions were observed. The difference of obstructive defecation syndrome (ODS) score before and after treatment in the observation group was greater than that in the control group (P < 0.05), and the recurrence rate was lower in the observation group than that in the control group (P < 0.05).Conclusions Oral administration of self-made Decoction for Tonifying Qi, Invigorating Spleen and Relaxing Bowel after transvaginal repair and EPH effectively ameliorates the clinical symptoms of outlet obstruction constipation caused by rectocele in female patients, improves the short-term and long-term treatment effects, reduces the recurrence rate, and does not increase the risk of adverse reactions.