Objective: To explore the relationship of Pi (脾)-deficiency syndrome in TCM with the change of serum high density lipoprotein (HDL) in blood lipid metabolic disorder. Methods: Sixty-eight patients with confirmed coronary heart disease (CHD) were selected for TCM syndrome typing into Pideficiency (PD) group and non-Pi-deficiency (NPD) group. Routine blood lipids and serum lipoprotein electrophoretogram (SLPG) were determined in all patients to analyze the total content of HDL and its relative contents of sub-components HDL1-5, as well as their relation with PD syndrome. Besides,a healthy control group (62 cases) was set up. Results: The level of serum HDL-C was lowered, SLPG abnormality rate increased in the patients with CHD, with total HDL and the relative contents of subcomponent HDL1 and HDL3 significantly lower than those in the healthy control group (P＜0.01). The total HDL, HDL1 and HDL3 in the PD group were also lower than those in the NPD group (P＜0.05,P＜0.01). Conclusion: Serum HDL and its sub-components showed a definite relation with TCM PD syndrome type, therefore, further exploring the granular specificity of HDL and its sub-components as well as their influence on reverse cholesterol transport (RCT) may hopefully provide clues for developing RCT regulatory Chinese new drugs and for CHD prevention and treatment.