Objective To explore the influence of Chinese patent herbal medicine Quxie Capsule（ QX） on advanced colorectal cancer（ CRC） patients’ serum metabolism and gut microbiome. Methods A double blinded randomized placebo-controlled clinical trial was used to intervene all participants by QX capsule or placebo for one month. The patients’ peripheral blood and stool samples before and after intervention were collected. LC-MS non-targeted metabolomics analysis and 16 SrRNA gut micro-biome analysis were used to preform difference and variance test through bio-analysis platform. Results Among all 40 patients who had been enrolled,34 of them finished all visits and were analyzed. Student’s test showed that the abundance of pelargonidin 3-sophoroside,3-amino-2-naphthoic acid and tryptophan betaine had increased after QX treatments. However,Niacinamide had declined after QX treatments and increased after placebo intervention. Joint analysis with gut microbiome showed that pelargonidin 3-sophoroside had positive association with distribution of gut Parasutterella and Lentisphaerae,and negative association with Streptococcus. Conclusion QX capsule could promote anti-cancer effect amomg advanced CRC patients through modulating Nicotinic acid and nicotinamide,Anthocyanin and tryptophan metabolism pathway,and maybe related to Quxie Capsule’s improving beneficial bacteria in intestinal tract and reducing the distribution ratio of harmful bacteria.