Abstract:Objective To study the clinical effects of fecal microbiota transplantation（FMT）in the treatment of anxiety and depression in patients with comorbid intestinal flora imbalance. Methods A total of 65 patients with depression or anxiety comorbid intestinal flora imbalance admitted to the Department of Gastrointestinal Surgery，Puren Hospital Affiliated to Wuhan University of Science and Technology from June 2024 to August 2024 were selected as the research subjects. Age and disease severity were used as covariates for stratified randomization. The experimental group received FMT assisted standard drug treatment，and the control group received standard drug treatment only，with 30 patients in each group. The intestinal barrier function levels of the two groups of patients were detected before treatment and at discharge，and the self?rating anxiety scale（SAS），self?rating depression scale（SDS）gastrointestinal symptom rating scale（GSRS），Pittsburgh sleep quality index（PSQI），Bristol Stool Scale scores of the two groups of patients were recorded by telephone follow ? up before treatment and one month after discharge. Results There was no significant difference in intestinal barrier function，depression and anxiety，gastrointestinal symptoms，sleep quality，and Bristol scale scores between the two groups before treatment（P>0.05）. After treatment，the above indicators of the two groups were lower than those before treatment，and those in the experimental group were significantly lower than in the control group，with statistically significant differences （P<0.05）. Conclusion FMT has better clinical efficacy than conventional treatment in the treatment of anxiety and depression in patients with comorbid intestinal flora imbalance，can repair intestinal barrier function，improve sleep quality，depression and anxiety，and relieve gastrointestinal symptoms，and has good clinical application value