Abstract： Objective： To observe the clinical efficacy of Wenyang Lishui Prescription combined with western medicine on congestive heart failure. Methods：A total of 100 cases of patients with congestive heart failure admitted to Zhoushan City Hospital of Traditional Chinese Medicine from January 2021 to March 2023 were divided into the control group and the treatment group according to the random number table method，each with 50 cases. The control group was given conventional western medicine symptomatic treatment， and the treatment group was additionally treated with Wenyang Lishui Prescription based on the treatment of the control group. Both groups were treated continuously for four weeks. The scores of traditional Chinese medicine （TCM） syndrome and the levels of myocardial energy metabolism indicators [left ventricular end-systolic circumferential wall stress （cESS）， myocardial energy expenditure （MEE）]， left ventricular ejection fraction （LVEF） ， heart rate variability indicators [root mean square of successive differences （RMSSD），standard deviation of all normal R-R intervals （SDNN）]，and myocardial injury markers [Nterminal pro-B-type natriuretic peptide （NT-proBNP）， free fatty acids （FFA）， cardiac troponin I （cTnI）] were compared before and after treatment in the two groups； the clinical efficacy and adverse reactions were evaluated. Results：The total effective rate was 94.00%（47/50） in the treatment group and 80.00%（40/50） in the control group， the difference being significant （P＜0.05）. After treatment， the scores of TCM syndrome symptoms and the levels of FFA， myocardial energy metabolism indicators （cESS， MEE） and NT-proBNP and cTnI in serum in the two groups were reduced when compared with those before treatment （P＜0.05） ， LVEF， and heart rate variability indicators （RMSSD， SDNN） were increased （P＜0.05）； the scores of TCM syndrome， FFA， myocardial energy metabolism indicator，and levels of NT-proBNP and cTnI in serum in the treatment group were lower than those in the control group（ P＜0.05），LVEF and heart rate variability indicator was higher than that in the control group（ P＜0.05）. The incidence of adverse reactions in the control group was 4.00% （2/50）， and that in the treatment group was 2.00% （1/50）， there being no significant difference （P＞0.05）. Conclusion： The combination of Wenyang Lishui Prescription with western medicine has a definite curative effect on the treatment of congestive heart failure，which can alleviate myocardial energy metabolism disorders and myocardial injury， reduce heart rate variability， and has high safety.