Abstract: Objective To study the effect of Tiaozhi Recipes on intestinal microflora of patients with metabolic syndrome (MS) with phlegm and blood stagnation. Methods Fifty-seven patients with metabolic syndrome with phlegm, blood stasis and cross-over syndrome treated in our hospital from April, 2016 to March, 2017 were divided into two groups according to different treatment methods:Tiaozhiji group (27 cases) and western medicine group (30 cases). The Tiaozhiji group was treated with Tiaozhi capsule, Western medicine group treated with metformin tablets, while 30 healthy volunteers were selected as blank control group. Fluorescent quantitative PCR method was used to quantitatively analyze the changes of intestinal flora in three groups. Results The Lactobacillus, Bifidobacterium, butyrate-producing bacteria in MS group were significantly lower than those in the control group (P<0.05). Enterobacter, sulfate-reducing bacteria was significantly higher than the control group (P<0.05), the total intestinal bacterial content between the two groups was no significant difference (P>0.05); Lactobacillus, Bifidobacterium content in both groups after treatment were significantly higher than those before treatment (P<0.05), Enterobacteriaceae, sulfate-reducing bacteria were significantly decreased than those before treatment (P<0.05), there were no significantly difference about butyrate-producing bacteria, intestinal bacteria than before treatment (P>0.05), the content of Lactobacillus in the Tiaozhiji group was significantly higher than that in the western medicine group (P<0.05), and the content of Enterobacter in the Tiaozhiji group was significantly lower than that of western medicine group (P<0.05), Bifidobacterium, butyrate-producing bacteria, sulfate-reducing bacteria and intestinal bacteria was not statistically difference significant between the two groups (P>0.05). Conclusion The structure of intestinal microflora in patients with metabolic syndrome has been changed, and Tiaozhiji granules can promote the growth of Lactobacillus and Bifidobacterium, inhibit the growth of sulfate-reducing bacteria and Enterobacteriaceae. It can improve the structure of intestinal flora, and play its role in the treatment of metabolic syndrome, worthy of clinical application.