$re = '/\n(?=Leistung\b)/m';
$str = 'Leistung Armeotraining ET Anzahl 1
Zusatz *TextZusatz_Anf1*
Leistung Atemtherapie 30 Anzahl 2
Leistung Aktivierungsgruppe Anzahl 3
Zusatz *TextZusatz_Anf3*';
$subst = "\n\n";
$result = preg_replace($re, $subst, $str);
echo "The result of the substitution is ".$result;
Please keep in mind that these code samples are automatically generated and are not guaranteed to work. If you find any syntax errors, feel free to submit a bug report. For a full regex reference for PHP, please visit: http://php.net/manual/en/ref.pcre.php