Objective To analyze the effect of traditional Chinese medicine fasting therapy on atherogenic index of plasma and metabolic indices in patients with metabolic syndrome.Methods A case-control study was conducted on 90 patients with metabolic syndrome who were treated at Wenzhou Traditional Chinese Medicine Hospital between June 2021 and June 2023.The patients were divided into two groups with 45 patients in each group using a random number table method.The control group was given a normal diet,while the observation group underwent traditional Chinese medicine fasting therapy.Blood lipid indexes,atherogenic index of plasma,Homeostasis Model Assessment of Insulin Resistance index,anthropometric indices,and oxidative stress response were compared between the two groups.Results After treatment,the levels of low-density lipoprotein cholesterol,total cholesterol,and triglyceride in the observation group were(2.11±0.26)mmol/L,(4.31±0.26)mmol/L,and(1.39±0.26)mmol/L,respectively.They were significantly lower than those in the control group[(2.95±0.34)mmol/L,(5.24±0.33)mmol/L,(2.68±0.41)mmol/L,t=13.16,14.85,17.82,all P<0.05].After treatment,the level of high-density lipoprotein cholesterol was significantly higher in the observation group than in the control group[(1.18±0.09)mmol/L vs.(1.03±0.04)mmol/L,t=10.21,P<0.001].After treatment,atherogenic index of plasma and Homeostasis Model Assessment of Insulin Resistance index in the observation group were(0.10±0.04)and(5.12±0.42),respectively in the observation group.They were significantly lower than those in the control group[(0.28±0.10),(5.80±0.67),t=11.21,5.76,both P<0.001].After treatment,waist circumference,hip circumference,and visceral adiposity index in the observation group were(91.05±4.26)cm,(98.16±5.06)cm,and(3.94±0.52),respectively.They were significantly lower than those in the control group[(95.55±9.87)cm,(102.64±9.84)cm,(5.66±1.04),t=2.80,2.71,9.92,all P<0.05).After treatment,the level of superoxide dismutase in the observation group was significantly higher than that in the control group[(101.52±13.52)U/mL vs.(80.01±6.82)U/mL,t=9.52,P<0.001].After treatment,the level of malondialdehyde in the observation group was significantly lower than that in the control group[(4.41±0.35)nmol/L vs.(6.26±0.61)nmol/L,t=17.64,P<0.001).Conclusion Traditional Chinese medicine fasting therapy can effectively reduce the atherogenic index of plasma,blood lipid level,waist circumference,hip circumference,and visceral adiposity index in patients with metabolic syndrome.It also reduces oxidative stress reactions and is highly effective.