In recent years, the prevalence of obesity has been increasing year by year, leading to a rise in serious complications. The pathogenesis of obesity is complicated in which the intestinal flora plays an important role. Intestinal micro ecology is composed of large and complex intestinal flora that participate in important physiological functions such as metabolism, energy conversion, maintaining intestinal mucosal defense function, and promoting immune system development and maturation and other important physiological functions;furthermore, they are influenced by the host’s genetic background, diet, and other factors. Therefore, intestinal microflora has potential as a new field of drug therapy. At present, it is found that traditional Chinese medicine therapy may prevent and treat obesity by interfering with the intestinal flora, which is expected to become one of the main treatment methods for obese patients. However, its mechanism of action remains unclear. The balance of intestinal flora can be adjusted by acupuncture, massage, and acupoint application. By analyzing the mechanism of obesity caused by intestinal micro ecology and the impact of obesity on the host’s intestinal micro ecological environment, this paper discusses the influence of oral Chinese medicine, acupuncture, massage, acupoint sticking, and other traditional Chinese medicine therapies on the intestinal microflora in obese patients and provides a scientific basis for its clinical application.