ObjectivesTo systematically review the efficacy of Qiliqiangxin capsule on cardiac function in patients with heart failure with preserved ejection fraction (HFpEF).MethodsCNKI, VIP, WanFang Data, CBM, EMbase, PubMed and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) of Qiliqiangxin capsule for HFpEF from inception to August 1st, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was performed by RevMan5.3 software.ResultsA total of 24 RCTs involving 2 021 patients were included. The results of meta-analysis showed that Qiliqiangxin capsule combined with conventional western medicine could improve E/A wave ratio (MD=0.17, 95%CI 0.13 to 0.21, P<0.000 01), reduce E/e' wave ratio (MD=−2.16, 95%CI −3.23 to −1.08, P<0.000 1), BNP (MD=−240.43, 95%CI −357.66 to −123.20, P<0.000 1), and NT-proBNP (MD=−200.64, 95%CI −290.02 to −111.27, P<0.000 1). However, there were no statistically significant differences between two groups in re-hospitalization rate (RR=0.57, 95%CI 0.27 to 1.19, P=0.13), mortality (RR=0.33, 95%CI 0.04 to 3.05, P=0.33), and incidence of adverse events (RR=0.59, 95%CI 0.26 to 1.34, P=0.20).ConclusionsThe present evidence shows that Qiliqiangxin capsule combined with conventional western medicine can improve neuroendocrine disorders and cardiac structure in patients with HFpEF, and further improve cardiac diastolic function. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.