Abstract: OBJECTIVE To observe the effect of Chinese herbal medicine Yiqi Huoxue recipe combined with sacubitril valsartan in the treatment of chronic heart failure and its influence on heart rate variability index, serum NT-proBNP and MMP-9 levels. METHODS One hundred and twenty-six patients with chronic heart failure admitted to July 2017 to August 2018 were randomly divided into the Shakuba group(61 cases) and the Yiqishaku group(65 cases). Basic treatment of anti-chronic heart failure and sacubitril valsartan treatment, Yiqishaku group on the basis of Shakuba group on the treatment of Yiqi Huoxue recipe, observed the clinical efficacy of the two groups after 6 months of treatment, heart rate variability index, serum NT-proBNP, MMP-9 and adverse reactions. RESULTS The total effective rate of the Yiqishaku group was significantly better than that of the Shakuba group(89.23% vs 72.13%)(χ²=5.979, P=0.031). After treatment, the two groups of heart rate variability indicators(SDNN, SDANN, pNN50) and NT-proBNP, MMP-9 were better than before treatment. The heart rate variability indicators SDNN, SDANN, and pNN50 were significantly higher in the Yiqishaku group than in the Shakuba group129.53±34.26 vs 114.28±31.84)ms, (112.31±36.02 vs 101.44±29.59)ms, (8.71±7.64 vs 6.37±5.80)%(P<0.05); Serum NT-proBNP and MMP-9 were significantly lower in the Yiqishaku group than in the Shakuba group(207.45±51.71 vs 268.62±74.15)pg·mL^-1, (561.79±64.03 vs 688.19±87.94)pg·mL^-1(P<0.05). CONCLUSION The traditional Chinese medicine Yiqi Huoxue recipe combined with sacubitril valsartan has a significant effect in the treatment of chronic heart failure. This treatment can improve the abnormality of heart rate variability index, NT-proBNP and MMP-9.