Objective To study the effect of dampness-eliminating and spleen-strengthening Prescription (ESP) on expression levels of adiponectin (APN) , tumor necrosis factor alpha (TNF-α) , and hepatic fat content in type 2 diabetes mellitus ( T2DM) patients complicated with non-alcoholic fatty liver disease ( NAFLD) . Methods One hundred and twenty T2DM patients complicated with NAFLD were randomized into ESP group and pioglitazone group, 60 cases in each group. Based on the fundamental treatment for decreasing glucose, ESP group and pioglitazone group were given oral use of ESP and pioglitazone respectively. Twenty-four weeks constituted one treatment course. Before and after treatment, we observed the hepatic fat content, serum concentrations of APN and TNF-α, blood glucose, blood lipid, and hepatic function with the virtual touch tissue quantification technique ( VTQ) , enzyme-linked immunosorbent assay ( ELISA) , biochemical analysator respeetively in the two groups. Results After treatment, the levels of fasting plasma glucose ( FPG) , 2-hour postprandial plasma glucose ( 2hPG) , glycosylated hemoglobin ( HbA1c) fasting insulin ( FINS) , total cholesterol ( TC) , triglyceride ( TG) , low density lipoprotein cholesterol ( LDL-C) and TNF-α, and hepatic acoustic radiation force impulse ( ARFI) scores in the two groups were significantly lower than those before treatment (P<0.05) . On the other hand, the serum levels of high density lipoprotein cholesterol (HDL-C) and APN in both groups were significantly higher than those before treatment ( P<0.05) . The difference values of FINS and NF-α before and after treatneat in ESP group were higher than those in pioglitazone group ( P<0.05) . Conclusion ESP can significantly ameliorate the metabolic disorders of glucose and lipid , protect the pancreatic function and reduce hepatic fat, which is possibly related with the increase of APN level and the de-crease TNF-αlevel.