Disclosed are a traditional Chinese medicine composition and a traditional Chinese medicine extract composition for treating metabolic syndrome. The traditional Chinese medicine composition consists of the following raw materials in the following weight ratio: 5-80% of Coptidis Rhizoma, 5-70% of Aurantii Fructus Immaturus, 0-60% of Pinelliae Rhizoma, 0-40% of Trichosanthis Fructus, 0-12% of Cinnamomi Cortex, and 10-60% of red yeast rice. The traditional Chinese medicine extract composition consists of the following raw materials in the following weight ratio: 2-30% of Coptidis Rhizoma extract, and 70-98% of a mixed extract from five traditional Chinese medicines comprising Aurantii Fructus Immaturus, Pinelliae Rhizoma, red yeast rice, Trichosanthis Fructus, and Cinnamomi Cortex. The traditional Chinese medicine composition or the traditional Chinese medicine extract composition contains the following active ingredients (mg/g): 6-122 mg/g of total alkaloids, which comprises 4-89 mg/g of berberine, 30-315 mg/g of total flavonoids, which comprises 20-186 mg/g of neohesperidin: and 0.5-9 mg/g of lovastatin. Further provided are preparation methods and applications of the above compositions.