Objective To explore the effects of graded exercise combined with traditional Chinese medicine （TCM） treatment based on syndrome differentiation on frailty in elderly patients with chronic heart failure of Yang deficiency type. Methods A total of 118 elderly patients with frailty and chronic heart failure of Yang deficiency type were enrolled as study participants. Using a time-based grouping method, 65 patients in the control group (July to December 2024) received routine cardiac rehabilitation nursing, while 65 patients in the intervention group (January to June 2025) received a rehabilitation program comprising graded exercise combined with TCM treatment based on syndrome differentiation. Results A total of 59 patients in each group completed the study. After one month of intervention, the frailty score and TCM syndrome score in the intervention group were significantly lower than those in the control group, and the improvement in activities of daily living was significantly better than that in the control group (all P<0.05). Conclusion Graded exercise combined with TCM treatment based on syndrome differentiation can improve frailty and symptoms in elderly patients with chronic heart failure of Yang deficiency type, thereby enhancing their activities of daily living.