Chinese medicine (CM) has a good clinical effect on osteoarthritis (OA)

but the mechanism is not very clear. Evidence-based medicine researches have shown that intestinal flora plays a role in the pathogenesis and succession of OA. Intestinal flora affects the efficacy of CM

and CM can affect the balance of intestinal flora. This paper focuses on the relationship between intestinal flora

intestinal microenvironment

brain-gut axis

metabolic immunity and OA

and preliminarily expound the significance of intestinal flora in the pathogenesis of OA and the mechanism of CM intervention. The above discussion will be of great significance in the prevention and treatment of OA by CM from the perspective of intestinal flora.