To observe the therapeutic effect of Xuefu Zhuyu Decoction on coronary heart disease(CHD)model rats and explore its effect on PI3K-AKT signaling pathway related proteins.Methods:A total of 45 SD rats were randomly divided into a blank group，a model group and a traditional Chinese medicine(TCM)group，with 15 rats in each group.CHD model was set up for the rats in the model group and the TCM group.The rats in TCM group were given 2 g/mL Xuefu Zhuyu Decoction by gavage.The rats in the blank group and the model group were given the same amount of normal saline by gavage.All the 3 groups were given gavage continuously for 10 days.The changes of ST segment，cardiomyocyte apoptosis，morphology of common carotid artery，blood lipid level，protein levels of PI3K，AKT and p-AKT in myocardial tissue，and the levels of Bax and Bcl-2 in abdominal aorta were observed before and after modeling.Results:1)ECG showed that the ST segment change of rats after CHD model preparation was higher than that of the blank group(P<0.05)，and the TCM group was better than that of the model group(P<0.05); 2)the blood lipid metabolism of rats after CHD model preparation was disordered，with a significant increase in TC，TG，LDL-C，Bax and a significant decrease in HDL-C，bcl-2; compared with the blank group，the differences were statistically significant(P<0.05).After the intervention of TCM，the blood lipid level of rats was higher than that of the model group(P<0.05); 3)TUNEL detection showed that the apoptosis rate of cardiomyocytes in the model group was higher than that of the blank group(P<0.05)，and the apoptosis rate of cardiomyocytes in the TCM group was lower than that of the model group(P<0.05); 4)HE staining showed that the thickness of the coronary artery wall in the blank group was uniform，the shape of the intima was regular，and the structure was complete; the intima-media in the model group was significantly thickened，the arterial wall was significantly uneven，the lumen was narrow，and obvious plaque appeared; the wall of the TCM group was smoother than that of the model group，and the plaque was smaller than the model group; 5)the levels of PI3K，p-AKT and Bcl-2 in the CHD model rats were lower than those in the blank group.The concentration of Bax in the control group was higher than that in the blank group(P<0.05)，and the improvement effect of the above indexes in the TCM group was better than that in the model group(P<0.05).Conclusion:Xuefu Zhuyu Decoction can significantly reverse the pathological changes of coronary heart disease，and its mechanism may be related to the inhibition of cardiomyocyte apoptosis.