Abstract： Objective： To observe the clinical efficacy of Shexiang Tongxin Dropping Pills combined with Telmisartan in treating heart failure of qi deficiency and blood stasis type. Methods：A total of 98 patients with heart failure of qi deficiency and blood stasis type admitted to the Department of Internal Medicine at Zhuji Central Hospital from January 2022 to January 2024 were selected and divided into the Telmisartan group and the combined traditional Chinese medicine（TCM） group using the random number table method， with 49 cases in each group. No cases dropped out during treatment. The Telmisartan group received Telmisartan alone， while the combined TCM group received Shexiang Tongxin Dropping Pills plus Telmisartan. Both groups were treated for 12 weeks. Clinical efficacy was compared between the two groups， along with changes in TCM syndrome scores， left ventricular ejection fraction （LVEF），6-minute walk test （6MWT），oxygenation index （OI），and serum levels of lactate （LAC），matrix metalloproteinase-9 （MMP-9）， and N-terminal pro-B-type natriuretic peptide （NT-proBNP） before and after treatment. Results： After treatment， the total effective rate in the combined TCM group was 95.92% （47/49）， significantly higher than 77.55% （38/49） in the Telmisartan group （P＜0.05）. TCM syndrome scores decreased in both groups compared to pretreatment （P＜0.05），with the combined TCM group showing lower scores than the Telmisartan group （P＜0.05）. LVEF improved in both groups （P＜0.05）， with the combined TCM group demonstrating higher values than the Telmisartan group （P＜0.05）. The 6MWT distance increased in both groups （P＜0.05）， with longer distances achieved in the combined TCM group （P＜0.05）. OI values increased in both groups （P＜0.05），with higher levels in the combined TCM group （P＜0.05）. Serum LAC levels decreased in both groups （P＜0.05）， with lower levels in the combined TCM group （P＜0.05）. MMP-9 and NT-proBNP levels decreased in both groups （P＜0.05）， with the combined TCM group showing greater reductions （P＜0.05）. Conclusion： Shexiang Tongxin Dropping Pills combined with Telmisartan can enhance therapeutic efficacy in the treatment of heart failure of qi deficiency and blood stasis type， improve cardiac and respiratory function， reduce blood LAC levels， ameliorate tissue perfusion and myocardial injury，with high safety.