Abstract： Objective： To analyze the characteristics and distribution patterns of traditional Chinese medicine syndrome types in patients with acute exacerbation of chronic heart failure （CHF） based on both conventional basic syndrome elements of deficiency in root and excess in branch as well as triple-energizer stagnation. Methods：A total of 190 patients with acute exacerbation of CHF were enrolled. Information required for traditional Chinese medicine syndrome diagnosis and relevant clinical data were collected. Frequencies of individual syndrome elements and their combinations were calculated. Two-step cluster analysis was employed to explore the distribution of major traditional Chinese medicine syndrome types. Results：① Among the eight basic syndrome elements identified in the 190 patients， pectoral qi deficiency， blood stasis， and primordial qi deficiency were the most prevalent. The majority of patients presented with varying degrees of triple energizer stagnation， among which upper energizer stagnation was the most common. ② Regarding the combination of deficiency-root and pathological factor syndrome elements，the coexistence of five and six syndrome elements was the most frequent， accounting for 35.8% and 26.8%， respectively. For the combination of deficiency-root and triple energizer stagnation syndrome elements， the coexistence of four and five syndrome elements was the most common， each accounting for 27.4%. ③ The predominant syndrome type was intermingled deficiency-excess ， with pure deficiency and pure excess types being relatively rare. ④A total of 54 combinations of deficiency-root and pathological factor syndrome elements were identified， which were classified into seven clusters by two-step clustering. All seven clusters featured primordial qi deficiency and/or pectoral qi deficiency； among them， six clusters included blood stasis， six included fluid retention， and five included phlegm turbidity. A total of 32 combinations of deficiency-root and triple energizer stagnation syndrome elements were identified， which were classified into four clusters by two-step clustering. All four clusters featured pectoral qi deficiency and upper energizer stagnation，and three of them included primordial qi deficiency. Conclusion：The core pathogenesis of acute exacerbation of CHF is rooted in pectoral qi deficiency and/or primordial qi deficiency，with blood stasis，phlegm turbidity，and fluid retention as the superficial manifestations，and pathological factors predominantly stagnating in the upper energizer. The basic syndrome type of acute exacerbation of CHF is pectoral-primordial qi deficiency with pathogen stagnation in the energizers，abbreviated as qi deficiency with energizer stagnation syndrome. This can be further classified into four subtypes： pectoral-primordial qi deficiency with pathogen stagnation in the energizers；deficiency of qi and yin with pathogen stagnation in the energizers；deficiency of qi and yang with pathogen stagnation in the energizers；and pectoral-primordial qi deficiency with energizer stagnation and heat depression.