Abstract： Objective： To observe the clinical effect of acupuncture combined with Chinese medicine fumigation at du mai on perimenopausal obesity (PMO) of spleen and kidney qi deficiency and internal abundance of phlegm-damp type. Methods： A total of 80 cases of PMO patients of spleen and kidney qi deficiency and internal abundance of phlegm-damp type were selected and divided into the control group and the treatment group according to the random number table method，with 40 cases in each group. The control group received acupuncture treatment，while the treatment group received acupuncture combined with Chinese medicine fumigation at du mai ， both groups were treated for four weeks. Compared the clinical efficacy，traditional Chinese medicine (TCM) syndrome scores，modified Kupperman scores，and obese degree indexes [body mass，body mass index (BMI)，waist circumference，hip circumference，and waist hip ratio (WHR)］ between the two groups. Results： After treatment， the total effective rate was 95.00% in the treatment group，higher than that of 77.50% in the control groupm (P＜0.05). The scores of various symptoms such as obesity，excessive phlegm and saliva，spiritual lassitude and fatigue，dizziness， tinnitus or deafness，hypaphrodisia preference for fatty and sweet foods，dry mouth and unwillingness to drink，and loose stools，as well as the total TCM syndrome scores in both groups were lower than those before treatment (P＜0.05). The above nine syndrome scores and the total TCM syndrome score in the treatment group were lower than those in the control group (P＜0.05). The modified Kupperman scores in both groups were lower than those before treatment (P＜0.05)，and the modified Kupperman score in the treatment group was lower than that in the control group (P＜0.05). The body mass， BMI， waist circumference，hip circumference，and WHR in both groups were lower than those before treatment (P＜ 0.05)， and the body mass， BMI， waist circumference， hip circumference， and WHR in the treatment group were lower than those in the control group (P＜0.05). Conclusion： Acupuncture combined with Chinese medicine fumigation at du mai has a good therapeutic effect on the treatment of PMO of spleen and kidney qi deficiency and internal abundance of phlegm-damp type， which can improve the symptoms of perimenopausal period in patients，reduce the obese degree.