Objective To evaluate the clinical efficacy of Qiwei Baizhu Powder（七味白术散） in the treatment of obesity of spleen deficiency and dampness disturbing. Methods A total of 34 obese patients with spleen deficiency and dampness disturbing were randomly divided into a treatment group（24 cases） and a control group（10 cases）. Patients in the control group were given guidance on lifestyle

controlled and regular diet

and appropriate exercise intervention; patients in the treatment group were additionally given Qiwei Baizhu Powder orally

1 dose per day. The course of treatment for both groups was 3 months. The scores of traditional Chinese medicine（TCM） syndromes

body mass index（BMI）

blood lipids including triglycerides（TG）

low-density lipoprotein（LDL） and high-density lipoprotein（HDL）

glucose metabolism indicators including fasting blood glucose（FBG）

fasting insulin（FINS）

glycosylated hemoglobin A1 c（HbA1 c）

insulin resistance index（HOMA-IR） and changes in the distribution of intestinal flora before and after treatment were compared. Results The scores of TCM syndromes

BMI

FINS

HOMA-IR

FBG

and TG in the treatment group were significantly lower than before treatment

and HDL was significantly increased（P<0.05 or P<0.01）. There was no statistical difference in all indicators in the control group before and after treatment（P>0.05）. The results of intestinal flora showed that at the phylum level

the increase of Bacteroides in the treatment group after treatment was higher than the that in the control group（P<0.05）. There was no statistically significant difference between groups in Bacillus phylum Firmicutes

Proteobacteria

Actinomycetes and Fusiform（P>0.05）. At the genus level

the Bacteroides and Prevotella in the treatment group increased significantly after treatment. Prevotella spp. was significantly decreased after treatment（P<0.05）. Conclusion Qiwei Baizhu Powder can effectively regulate the distribution of intestinal flora in obese patients with spleen deficiency and dampness disturbing

and can improve blood sugar and blood lipid metabolism.