const DigitalSigCtrl = 719
const EncryptMsgCtrl = 718

Dim myItem as Outlook.MailItem
Dim myInspector as Outlook.Inspector
Dim odDigSignCtl as CommandBarControl
Dim oEncryptMsg as CommandBarControl
Dim oCBs as CommandBar

Set myItem = Outlook.CreateItem(olMailItem)
myItem.To =  "123@mail.ru"
myItem.Subject = "Subj"
myItem.Body = "123"
Set Inspector = myItem.GetInspector
myInspector.Display
Set oCBs = myInspector.CommandBars(6)
Set oDigSignCtl = oCBs.FindControl(msoControlButton, DigitalSigCtrl, "", True)
Set oEncryptMsg = oCBs.FindControl(msoControlButton, EncryptMsgCtrl, "", True)

oDigSignCtl.Execute
oEncryptMsg.Execute
myItem.Send