Abstract：Objective：To observe the effect of Qidan Granules combined with Metformin Hydrochloride on insulin resistance，serum nuclear factor- κB (NF- κB) and tumor necrosis factor- α (TNF- α) in patients with type 2 diabetes mellitus (T2DM) of spleen deficiency and obstruction of phlegm and blood stasis type. Methods： A total of 100 patients with T2DM of spleen deficiency and obstruction of phlegm and blood stasis type were selected and divided into the treatment group and the control group according to the random number table method， with 50 cases in each group. The control group was given Metformin Hydrochloride， and the treatment group was given Metformin Hydrochloride combined with Qidan Granules. After 8 weeks of treatment， the clinical effects in the two groups were compared， and the changes of traditional Chinese medicine (TCM) syndrome scores， Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)，body mass index (BMI)，abdominal circumference (AC)，blood lipids [total cholesterol (TC)， triglyceride (TG)， low density lipoprotein (LDL-C)， high density lipoprotein (HLD-C)]， serum NF- κB and TNF- α were compared before and after treatment between the two groups. Results： After treatment， the total effective rate was 80.00% in the control group and 94.00% in the treatment group，the difference being significant (P＜0.05). After treatment，the TCM scores in the two groups were decreased when compared with those before treatment (P＜0.05)， and the TCM syndrome score in the treatment group was lower than that in the control group (P＜0.05). After treatment，the levels of HOMAIR， BMI， and AC in the two groups were decreased when compared with those before treatment (P＜ 0.05)， and the levels of HOMA-IR， BMI， and AC in the treatment group were lower than those in the control group (P＜0.05). After treatment， the levels of TC， TG， and LDL-C in the two groups were decreased when compared with those before treatment (P＜0.05)， and the HLD-C levels was increased when compared with those before treatment (P＜0.05)；the levels of TC，TG，and LDL-C in the treatment group were lower than those in the control group，the difference being significant (P＜0.05)；there was no significant difference in the HDL-C level between the two groups (P＞0.05). After treatment，the levels of serum NF-κB and TNF-α in the two groups were decreased when compared with those before treatment， and the levels of serum NF- κB and TNF- α in the treatment group were decreased when compared with those in the control group (P＜0.05)；the levels of serum NF- κB and TNF- α in the treatment group were lower than those in the control group (P＜0.05). Conclusion：The therapy of Qidan Granules combined with Metformin Hydrochloride can significantly improve insulin resistance in patients with T2DM of spleen deficiency and obstruction of phlegm and blood stasis type， down-regulate levels of serum NF- κB and TNF-α，improve inflammatory response of adipose tissue，and alleviate clinical symptoms.