Abstract： Objective： To observe the clinical effect of Shexiang Baoxin Pills combined with routine western medicine for coronary heart disease in the senile. Methods：A total of 130 cases of senile patients with coronary heart disease were divided into the study group and the control group according to the random number table method， with 65 cases in each group. The control group was treated with routine western medicine， and the study group was additionally treated with Shexiang Baoxin Pills based on the treatment of the control group. The clinical effects in the two groups were evaluated. Before and after treatment， the changes in inflammatory factors and expressions of micro RNA- 126 in peripheral blood were compared between the two groups. The incidence of adverse reactions was observed. Results：The total effective rate was 98.46% in the study group， higher than that of 89.23% in the control group(P＜ 0.05). Before treatment， there was no significant difference being found in the comparison of levels of tumor necrosis factor- α(TNF- α) and high- sensitivity C- reactive protein(hs- CRP) in serum between the two groups(P＞0.05). After treatment，the levels of TNF-α and hs-CRP in serum in the two groups were lower than those before treatment(P＜0.05)， and the levels of TNF- α and hs- CRP in serum in the observation group were lower than those in the control group(P＜0.05). Before treatment， there was no significant difference being found in the comparison of expression levels of micro RNA- 126 in serum between the two groups(P＞0.05). After treatment，the expression levels of micro RNA- 126 in serum in the two groups were higher than those before treatment(P＜0.05)，and the expression level of micro RNA- 126 in serum in the study group was higher than that in the control group(P＜0.05). There was no significant difference being found in the comparison of incidence of adverse reactions between the two groups(P＞ 0.05). Conclusion： Shexiang Baoxin Pills combined with routine western medicine for coronary heart disease in the senile can promote the expression of micro RNA- 126 in peripheral blood and inhibit the generation of inflammatory factors，so as to improve the curative effect.