Objective: To explore the effect of Zhenwu Decoction combined with trimetazidine in the treatment of dilated cardiomyopathy (DCM). Methods: 94 patients with DCM admitted to the vascular department of our hospital from June 2021 to June 2023 were selected as the study objects. The patients were divided into control group and observation group by random number table, with 47 cases in each group. The control group was treated with trimetazidine. Observation group was treated with Zhenwu decoction on the basis of control group. The efficacy, cardiac function [left ventricular end-diastolic diameter (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD)], inflammatory factor levels [soluble intercellular adhesion molecule 1 (sICAM-1), serum tumor necrosis fact-α (TNF-α)] and the occurrence of adverse reactions were analyzed and compared between the two groups Situation. Results: After treatment, the total effective rate of observation group was significantly higher than that of control group (P < 0.05). After treatment, LVEDD and LVESD in both groups were significantly lower than before treatment, and LVEF was significantly higher than before treatment. LVEDD and LVESD in observation group were significantly lower than those in control group, and LVEF was significantly higher than that in control group (P < 0.05). After treatment, the levels of TNF-α and sICAM-1 in both groups were significantly lower than before treatment, and the levels of TNF-α and sICAM-1 in observation group were significantly lower than those in control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: Zhenwu Decoction combined with trimetazidine in the treatment of DCM can improve the efficacy, improve the cardiac function of patients, relieve inflammation, and do not increase adverse reactions, with high safety.