In the context of urbanization, with the change of modern people"s diet structure and the increase of life pressure, the incidence rate of IBS-D has increased year by year, which has greatly affected people"s quality of life; At the same time, the incidence of metabolic diseases? such as obesity, diabetes, nonalcoholic fatty liver disease has been increasing, and its related multisystem damage has become a hot issue of concern. At present, relevant research has formed a relatively systematic understanding of the independent pathogenesis of these two diseases, but the pathological and physiological mechanisMetS oftheir comorbidity are still unclear. In this regard, this? article mainly? focuses? on? the? abnormal? regulation? of the? brain? gut? axis? and? the? imbalance? of intestinal microbiota, and? systematically? reviews? and? sorts? out? literature? related? to metabolic? syndrome? and? IBS-D.? In addition,? this? article? also? explores? the? correlation? and? related? mechanisMetS? between? IBS-D? and? metabolic abnormalities from the perspective of "spleen mediated transport"; This can provide ideas and references? for establishing a precision treatment system that combines traditional Chinese and Western medicine.