To investigate the effects of Huangqi Sijunzi Decoction combined with metformin hydrochloride on serum TNF-α，IL-6，adiponectin and maternal and infant outcomes in pregnant women with gestational diabetes mellitus.Methods:A total of 120 GDM patients admitted to Guangzhou Women and Children's Medical Center from January 2019 to December 2019 were selected as the study subjects，and all patients were randomly divided into 2 groups according to the numerical method.The control group(60 cases) was treated with metformin hydrochloride，and the observation group(60 cases) was additionally treated with Astragalus Sijunzi Decoction.Clinical efficacy，TCM syndrome score and maternal and infant outcomes of 2 groups were counted.The levels of tumor necrosis factor(TNF-α)，interleukin-6(IL-6)，C-reactive protein(CRP) and fasting insulin(FINS) were measured，and the insulin resistance index(HOMA-IR) was calculated.Results:The total effective rate and adiponectin level of the observation group were higher than those of the control group(P<0.05).After treatment，the indexes of TNF-α，CRP，IL-6，FINS and HOMA-IR in the observation group were significantly lower than those in the control group(P<0.05).The incidences of adverse outcomes were lower than those in the control group(P<0.05).Conclusion:Huangqi Sijunzi Decoction combined with metformin hydrochloride can improve the clinical treatment effect，reduce inflammation，increase adiponectin level，reduce insulin resistance，and improve the outcome of maternal and infant.