Abstract： Objective To study the efficacy and effects of Yangxin JianPi decoction on heart rate variability and serum factors in patients with heart failure(HF).Methods A total of 100 HF patients admitted to our hospital from January 2022 to October 2023 were retrospectively selected and divided into control group and study group according to the treatment plan,with 50 cases in each group.The control group was treated with trimetazidine,and the study group was treated with Yangxin JianPi Decoction on the basis of the control group.The clinical efficacy,TCM pattern scores,heart rate variability indexes[standard deviation of normal sinus heart interval(SDNN),root mean square of normal adjacent sinus heart interval difference(RMSSD),standard deviation of sinus RR interval per 5 minNN segment(SDANN),difference between adjacent sinus heart beats>%of 50 ms heart beat rate(PNN50)]serum cytokines[hypersensitive C-reactive protein(hs-CRP),brain natriuretic peptide B type B(BNP),Histone deacetylase 2(HDAC2),secreted coil-associated protein 2(SFRP2)]levels,and incidence of adverse reactions were compared between the two groups.Results The total clinical effective rate of the study group(96.00%)was higher than that of the control group(82.00%)(P<0.05),the scores of e-dema,asthma,palpitations and chills in the study group were lower than those in the control group(P<0.05)after 1 month of treatment,the levels of SDNN,RMSSD,SDANN and PNN50 in the study group were higher than those in the control group(P<0.05)after 1 month of treatment,and the serum levels of hs-CRP,BNP and HDAC2 in the study group were lower than those in the control group after 1 month of treatment.The level of SFRP2 was higher than that of the control group(P<0.05),and the total incidence of adverse reactions in the study group(12.00%)was not significantly different from that in the control group(8.00%)(P>0.05).Conclusion The combi-nation of Yangxin JianPi decoction and trimetazidine can effectively promote the improvement of heart rate variability,alleviate the in-flammatory state and clinical symptoms,enhance the efficacy,and have good safety in HF patients.