OBJECTIVE： To observe the efficacy of Shenmai injection combined with insulin in the intensive treatment of stress hyperglycemia in the septicopyemia patients. METHODS： The data of 156 septicopyemia patients with stress hyperglycemia was collected Retrospectively，according to the different medication divided into control group （78 cases） and observation group （78 cases）.All patients determined the pathogenic bacteria and received related anti-infection treatment， improving ventilation state， adequate fluid resuscitation support， immune therapy， nutritional support and other conventional treatment； based on it， control group received different dosages of insulin [1 U/ml， intravenous micro pump， with speed of 0.1 U/（kg·h）] based on different blood glucose levels； observation group additionally received 40 ml Shenmai injection， adding into insulin mixed solution， intravenous micro pump. Endpoint events（mortality）， recovering time of blood glucose， total dosage of insulin， basic indicators [Acute physiology and chronic health （24 APACHE-Ⅱ） score， mechanical ventilation time， hospitalization days in ICU and frequency of hypoglycaemia] and the incidence of adverse reactions in 2 groups were observed. RESULTS： The total mortality rate in observation group was significantly lower than control group， recovering time of blood glucose was significantly shorter than control group， the total dosage of insulin was significnatly less than control group， mechanical ventilation time was significantly shorter than control group，hospitalization days in ICU was significantly less than control group，the differences were statistically significant （P＜0.05）.before treatment， there were no significant differences in the 24 APACHE-Ⅱ score in 2 groups （P＞0.05）； after treatment， the 24 APACHE-Ⅱ score in 2 groups were significantly reduced， and observation group was lower than control group， the differences were statistically significant （P＜0.05）. And there were no obvious adverse reactions in 2 groups during treatment. CONCLUSIONS： Based on conventional treatment， Shenmai injection combined with insulin shows good efficacy in the intensive treatment of stress hyperglycemia in the septicopyemia patients， it can decrease total dosage of insulin， reduce mortality rate and 24 APACHE-Ⅱ score， shorten mechanical ventilation time and decrease hospitalization days in ICU，with good safety.