Background and Objective: Diabetic cardiomyopathy is a specific complication of diabetic heart disease and its etiology and mechanisms are not yet fully understood. Astragalus membranaceus is a commonly used traditional Chinese medicinal herb. This work demonstrated the impact of Astragalus membranaceus extract on glycemic and lipid metabolism disturbances as well as myocardial injury in patients with diabetic cardiomyopathy. Materials and Methods: In this research, qualitative analysis of Astragalus membranaceus extract injection was conducted using liquid chromatography. The 96 patients with type 2 diabetic cardiomyopathy were recruited and rolled into the control group (CG) treated with rosiglitazone tablets and the observation group (OG) treated with rosiglitazone tablets in combination with Astragalus membranaceus extract injection. After treatment, changes in patients' serum glucose metabolism, lipid metabolism, myocardial injury markers and adhesion molecule levels were assessed and echocardiography was employed to evaluate differences in left ventricular (LV) structure and function among the patients. Results: The characteristic chromatographic profile of Astragalus membranaceus extract injection exhibited marked changes in polar compounds within the 0- 10 min range. Serum analysis indicated that relative to CG, patients in OG exhibited decreased fasting blood glucose, glycated hemoglobin, triglycerides, total cholesterol, low-density lipoprotein cholesterol, creatine kinase-MB, creatine kinase, soluble vascular cell adhesion molecule-1 and soluble intercellular adhesion molecule-1, along with increased high-density lipoprotein cholesterol (p<0.05). Ultrasound structural analysis demonstrated that, in comparison to CG, patients in OG had reduced dimensions of the left ventricle and left atrium at end-systole, while LV ejection fraction, short-axis fractional shortening and the ratio of early to late diastolic peak flow velocities increased (p<0.05). Conclusion: In summary, Astragalus membranaceus extract injection was found to restore normal glycemic and lipid profiles, improve myocardial injury markers, promote LV remodeling, enhance LV diastolic and systolic function and exert cardioprotective effects by reducing cardiac adhesion molecule levels in patients with type 2 diabetic cardiomyopathy.