Abstract： Objective： To observe the clinical efficacy and safety of hot compress with Euodiae Fructus on gastrointestinal dysfunction in patients undergoing maintenance peritoneal dialysis （PD）. Methods ： A total of 76 patients with end-stage renal disease who underwent maintenance PD and presented with gastrointestinal dysfunction， hospitalized in the Department of Nephrology of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from April 2023 to April 2024， were randomly divided into the control group （37 cases） and the observation group （39 cases） using the random number table method. Both groups received conventional treatment. The control group was treated with coarse salt hot compress，while the observation group was treated with Euodiae Fructus combined with coarse salt hot compress. After seven days of treatment， the nutritional status [Patient-Generated Subjective Global Assessment （PG-SGA）] scale， the Chinese version of the Gastrointestinal Symptom Rating Scale （GSRS-C） ， incidence of adverse reactions， and levels of laboratory parameters including serum creatinine （SCr）， blood urea nitrogen （BUN）， albumin （Alb）， prealbumin （PA）， hemoglobin （HGB）， serum potassium （K），serum calcium （Ca），and serum phosphorus （P） were compared between the two groups. Results： After treatment，the GSRS-C scores in both groups decreased compared with those before treatment，and the score in the observation group was lower than that in the control group， with a statistically significant difference （P＜0.05）. After treatment，the PG-SGA score in the observation group decreased compared with that before treatment （P＜0.05）， but the difference was not statistically significant compared with the control group （P＞0.05）. The PG-SGA score in the control group showed no statistically significant difference before and after treatment （P＞0.05）. Before treatment，there were no statistically significant differences between the two groups in laboratory parameters including SCr，BUN，Alb， PA，HGB，serum P，serum K，and serum Ca（ P＞0.05）. After treatment，the serum K level in the observation group increased compared with that before treatment and was higher than that in the control group；no statistically significant differences were found in the other laboratory parameters between the two groups （P＞0.05）. Using the primary and secondary outcome indicators as dependent variables， and group， time， group×time， sex， age， disease duration， PD vintage， and duration of gastrointestinal symptoms as independent variables， a mixed-effects model was established. The analysis showed that in terms of PA level，serum K level，PG-SGA score，and GSRS-C score，the changes from baseline to after treatment in the observation group were statistically significant compared with those in the control group （P＜0.05）. During treatment，no adverse reactions related to hot compress were observed in either group. Conclusion： Hot compress with Euodiae Fructus was effective in relieving gastrointestinal dysfunction symptoms in patients undergoing maintenance PD with high safety，and also exerted an ameliorating effect on hypokalemia in these patients.