Objective: To explore the clin. effects of modified Gualou Xiebai Guizhi Decoction on lipid metabolism plasma heme oxygenase-1 (HO-1) and matrix metalloproteinase-9 (MMP-9) in elderly patients with coronary heart disease, so as to explore the therapeutic mechanism of Gualou Xiebai Guizhi Decoction on elderly patients with coronary heart disease and lay a foundation for optimizing the therapeutic regimen.Methods: A total of 104 elderly patients with coronary heart disease from Dec. 2015 to Dec. 2017 in Xiangyang First People′s Hospital were selected as the study subjects.According to the order of grouping, odd numbers were included in the control group, and even numbers were included in the observation group, with 52 cases in each group.Both groups of patients were given comprehensive treatment according to the routine diagnosis and treatment guidelines of coronary heart disease.On this basis, modified Gualou Xiebai Guizhi Decoction was added.The 2 groups were treated for 2 mo.The changes of blood lipid metabolism (TC, TG, HDL-C, LDL-C, OGTT), plasma HO-1, MMP-9, and hemodynamics (SV, CO, CI, LVEDP, AC) before and after treatment were compared between the 2 groups.The rates of adverse cardiovascular events and adverse drug reactions/side effects and the clin. curative effect rate after treatment were compared between the 2 groups.Results: 1) After treatment, TC, TG, LDL-C and OGTT of the 2 groups were significantly decreased than those before treatment, and the observation group was lower than the control group (P<0.05).HDL-C was significantly increased than before treatment, and the observation group was higher than the control group (P<0.05).2) After treatment, the level of HO-1 was significantly increased in the observation group than in the control group (P<0.05), and the level of MMP-9 was significantly decreased in the observation group than in the control group (P<0.05).3) After treatment, SV, CO, CI, AC in both groups were significantly higher than before treatment, and the observation group was higher than the control group (P>0.05).LVEDP were significantly decreased than before treatment, and the observation group was lower than the control group (P<0.05).4) The incidence of adverse cardiovascular events in the observation group was significantly lower than that in the control group (P<0.05).5) No serious adverse drug reactions/toxic side effects were collected during the treatment of the 2 groups.There was no significant difference between the 2 groups (P>0.05).6) After treatment, the total effective rate of the observation group was significantly higher than that of the control group (P<0.05).Conclusion: Modified Gualou Xiebai Guizhi Decoction can effectively improve lipid metabolism, enhance hemodynamic function enhance HO-1, reduce MMP-9, reduce the incidence of adverse cardiovascular events in elderly patients with coronary heart disease, and achieve the effect of improving clin. efficacy in many ways.It has high clin. value.