OBJECTIVE:To examine whether direct contact moxibustion(DCM) can prevent and treat gastric cancer(GC) by regulating intestinal flora in rats.METHODS:Male Wistar rats were randomly divided into normal group, normal+DCM control group, model group, and model+DCM group. Gastric cancer rats were induced by N-methyl-N-nitro-N-nitrosoguanidine(MNNG, 20 mg/mL) by gavage. At the same time, the model rats and normal rats were given DCM at Zusanli(ST36), Weishu(BL21), and Zhongwan(CV12) for 16 weeks. After treatment, gastric tissues were collected to analyze the pathological changes and the apoptosis of gastric mucosa cells. In addition, the cecal stool was taken and analyzed by 16 s r RNA sequencing.RESULTS:Gastric cancer-like pathological changes and different abundance of the intestinal flora were found in the model group. DCM promoted mucosa tissue apoptosis and regulated the abnormal changes of the intestinal microflora caused by MNNG; DCM also inhibited the growth of Ruminococcaceae and Prevotellaceae flora and promoted the growth of probiotic Akkermansia. Furthermore,DCM made the composition and abundance of intestinal microflora in the GC rats tending to the normal rats.CONCLUSION:DCM stimulating Zusanli(ST36),Weishu(BL21), and Zhongwan(CV12) promoted the apoptosis of gastric mucosa and delayed the progression of gastric cancer, possibly by decreasing Ruminococcaceae and Prevotellaceae bacteria(bacteria that produce short-chain fatty acids in the intestine) and promoting the growth of probiotic Akkermansia.