Objective  To observe the clinical effect of Huangqi Yixin Decoction combined with sacubitril/valsartan in treatment of patients with heart failure with preserved ejection fraction (HFpEF) of Qi deficiency and blood stasis type.

Methods  A total of 86 patients with HFpEF of Qi deficiency and blood stasis type were randomly divided into western medicine group and combination group using the random number table method, with 43 cases in each group. The western medicine group was treated with sacubitril/valsartan sodium tablets on the basis of conventional anti-heart failure therapy, while the combination group was additionally treated with Huangqi Yixin Decoction on the basis of the western medicine group′s treatment. The therapeutic efficacy, traditional Chinese medicine (TCM) syndrome scores, cardiac function indicators Tei index, N-terminal pro-brain natriuretic peptide (NT-proBNP), exercise tolerance 6-minute walk distance (6MWD), maximum exercise heart rate, metabolic equivalent (MET), and the occurrence of adverse reactions were compared between the two groups.

Results  The overall clinical effective rate in the combination group was 93.02%, which was higher than that in the western medicine group (76.74%), and the difference was statistically significant (P < 0.05). After treatment, the TCM syndrome scores in both groups were lower than those before treatment, and the scores in the combination group were lower than those in the western medicine group, with a statistically significant difference (P < 0.05). After treatment, the levels of Tei index and NT-proBNP in both groups were lower than those before treatment, and the levels in the combination group were lower than those in the western medicine group, with a statistically significant difference (P < 0.05). After treatment, the 6MWD, maximum exercise heart rate, and MET in both groups were higher than those before treatment, and the values in the combination group were higher than those in the western medicine group, with a statistically significant difference (P < 0.05). The incidence of adverse reactions in the western medicine group was 18.60%, which was higher than that in the combination group (4.65%), and the difference was statistically significant (P < 0.05).

Conclusion  Huangqi Yixin Decoction combined with sacubitril/valsartan has a good therapeutic effect on HFpEF of Qi deficiency and blood stasis type. It can reduce the TCM syndrome scores of patients, improve exercise tolerance, and has good safety.