Abstract: OBJECTIVE To investigate the therapeutic effect of Jiangzhi Decoction on non-alcoholic fatty liver disease(NAFLD) and its effect on gut microbiota and metabolism. METHODS The 13 NAFLD patients were selected as the patient group and 15 healthy volunteers were selected as the healthy group. The patient group were treated with Jiangzhi Decoction and explored the therapeutic effect via the mechanism of plasma glucose and lipoid, function of islets of langerhans and liver after 3 months, the changes of gut microbiota abundance in fecal samples were determined by 16S rRNA sequencing technology and the changes of metabolites in fecal samples were determined by metabonomics technology. RESULTS There was a big change on gut microbiota structure in NAFLD patients with a significant decreased diversity(P<0.05) and Megamonas was dominant, Jiangzhi Decoction could significantly decrease NAFLD patients' liver hardness and improve the mechanism of plasma glucose and lipoid, function of islets of langerhans and liver with 3 months treatment. The relative abundance of Blautia in the gut was significantly increased(P<0.05) and Faecalibacterium, Blautia and Bacteroides were dominant. Compared with the pre-treatment group, the fecal metabolites of patients in the post-treatment group were significantly up-regulated by 68, significantly down-regulated by 43(P all<0.05). There were significant differences in pyrimidine metabolism function and so on(P<0.05). CONCLUSION Jiangzhi Decoction has good therapeutic effect on NAFLD and can regulate intestinal flora and metabolic function in patients with NAFLD.