Abstract： Objective： To observe the clinical effect of traditional Chinese medicine (TCM) syndrome differentiation and treatment for diffuse toxic goiter (Graves) complicated with abnormal glucose metabolism. Methods： A total of 120 cases of patients with Graves disease complicated with abnormal glucose metabolism were selected as the study subjects and divided into the control group and the observation group according to the random number table method，with 60 cases in each group. The control group was treated with routine western medicine， and the observation group was treated with routine western medicine and Chinese medicine syndrome differentiation and treatment. Clinical effects were compared between the two groups. TCM syndrome scores， blood glucose related indexes， and thyroid hormone indexes were compared before and after treatment between the two groups. The correlation between hemoglobin A1C (HbA1c) and thyroid hormone was analyzed. Results：The total effective rate of treatment was 95.00% in the observation group，higher than that of 81.67% in the control group (P＜0.05). Before treatment， there was no significant difference being found in the comparison of TCM syndrome scores between the two groups (P＞0.05)；after one and two courses of treatment，TCM syndrome scores in the two groups were decreased (P＜0.05)， and the scores in the observation group were lower than those in the control group in the same period (P＜0.05). Before treatment， there was no significant difference being found in the comparison of the levels of HbA1c， fasting blood glucose (FBG)， and postprandial 2-hour blood glucose (P2hBG) between the two groups (P＞0.05)；after treatment，the levels of HbA1c， FBG， and P2hBG in the two groups were decreased (P＜0.05)， and the three levels in the observation group were lower than those in the control group (P＜0.05). Before treatment，there was no significant difference being found in the comparison of the levels of free triiodothyronine (FT3)， free thyroxine (FT4)，and thyrotropin (TSH) in serum between the two groups (P＞0.05)；after treatment，the levels of FT3 and FT4 in the two groups were decreased (P＜0.05)，and the two levels in the observation group were lower than those in the control group (P＜0.05)；TSH levels in the two groups were increased (P＜0.05)，and the TSH level in the observation group was higher than that in the control group (P＜0.05). After treatment，there was a positive correlation between TSH and HbA1c in the control group (r=0.263， P＜0.001)，and the correlation between TSH and HbA1c in the observation group was positive (r=0.035，P= 0.006). Conclusion： TCM syndrone differentiation and treatment for Graves disease complicated with abnormal glucose metabolism can better regulate hormone levels and lower blood glucose values on the basis of improving the total clinical effective rates and clinical symptoms. The increase of TSH will increase the risk of abnormal glucose metabolism.