Abstract：Objective：To observe the clinical efficacy of the traditional Chinese medicine "five-step" intervention strategy combined with auricular point thumbtack needling in treating polycystic ovary syndrome （PCOS） of phlegm- dampness type. Methods： A total of 84 PCOS patients of phlegm-dampness type treated at Wuyi County Hospital of Traditional Chinese Medicine from September 2023 to September 2024 were selected and randomly divided into the control group and the combination group using the random number table method, with 42 cases in each group. Both groups were treated with Ethinylestradiol and Cyproterone Acetate Tablets. The control group additionally received auricular point thumbtack needling， while the combination group received a traditional Chinese medicine "five-step" intervention strategy combined with auricular point thumbtack needling. Comparisons were made between the two groups regarding body mass index（ BMI），waist-to-hip ratio（ WHR），lipid and glucose metabolism indicators [triglycerides（ TG）， low-density lipoprotein cholesterol （LDL-C）， fasting plasma glucose （FPG）， Homeostasis Model Assessment of Insulin Resistance （HOMA-IR）]，serum sex hormone levels [testosterone （T），luteinizing hormone （LH），folliclestimulating hormone （FSH）， LH/FSH ratio]， traditional Chinese medicine syndrome scores， psychological status [Generalized Anxiety Disorder Scale （GAD-7）]， self-efficacy [General Self-Efficacy Scale （GSES）]， and quality of life [Modified Polycystic Ovary Syndrome Quality of Life Questionnaire （MPCOSQ）]. Results：After treatment，BMI and WHR decreased in both groups compared to before treatment （P＜0.05）， with lower values in the combination group （P＜0.05）. TG， LDL-C， FPG， and HOMA-IR levels decreased in both groups compared to before treatment （P＜0.05）， with lower levels in the combination group （P＜0.05）. T， LH， FSH， and LH/FSH ratio decreased in both groups compared to before treatment （P＜0.05）， with lower levels in the combination group （P＜ 0.05）. Traditional Chinese medicine syndrome scores and GAD-7 scores decreased in both groups compared to before treatment （P＜0.05），with lower scores in the combination group （P＜0.05）. GSES and MPCOSQ scores increased in both groups compared to before treatment （P＜0.05）， with higher scores in the combination group （P＜0.05）. Conclusion： The traditional Chinese medicine "five-step" intervention strategy combined with auricular point thumbtack needling can reduce obesity-related signs，improve endocrine function，regulate psychological status，and enhance quality of life in PCOS patients of phlegm-dampness type.