目的 研究吸气肌训练（IMT）联合体外膈肌起搏（EDP）对老年慢性心衰（CHF）患者的疗效。 方法 选取西安交通大学第二附属医院心内科2024年3月至2024年10月收治住院的CHF患者147例，其中常规药物治疗组患者38例（常规组），常规药物治疗＋EDP治疗的患者52例（双联治疗组），常规药物治疗＋EDP治疗＋IMT治疗的患者57例（三联治疗组），探讨三组患者治疗前、治疗4周后最大吸气压（MIP）、最大呼气压（MEP）、握力、6分钟步行试验距离（6MWD）、改良呼吸困难指数（mMRC）评分、静息心率、静息血压的差异。 结果 治疗后，双联治疗组MIP、6MWD高于常规组（P < 0.05），mMRC评分低于常规组（P < 0.05）；三联治疗组MIP、MEP、握力、6MWD高于常规组及双联治疗组（P < 0.05），mMRC评分低于常规组及双联治疗组（P < 0.05），静息收缩压低于双联治疗组（P < 0.05），静息心率低于常规组（P < 0.05）。 结论 IMT联合EDP可显著提升CHF患者的呼吸肌肌力及上肢肌力，有效改善心肺功能，缓解呼吸困难，并降低静息心率及血压，进而改善生活质量，值得临床推广应用。

Objective To investigate the therapeutic efficacy of inspiratory muscle training （IMT） combined with external diaphragm pacing （EDP） in elderly patients with chronic heart failure （CHF）. Methods 147 patients with CHF admitted to the Department of Cardiology of the Second Affiliated Hospital of Xi'an Jiaotong University from March 2024 to October 2024 were selected， of which 38 patients were in the conventional drug therapy group （standard care group）， 52 patients were in the conventional drug therapy + EDP therapy （dual therapy group）， and 57 patients were in the conventional drug therapy + EDP therapy + IMT therapy （triple therapy group）. Comparative analyses were performed for maximum inspiratory pressure （MIP）， maximum expiratory pressure （MEP）， handgrip strength， 6-minute walk distance （6MWD）， modified Medical Research Council （mMRC） scores， resting heart rate， and blood pressure before treatment and 4 weeks post-intervention. Results After treatment， The dual therapy group demonstrated higher MIP， 6MWD， and lower mMRC scores than the standard care group （P < 0.05）. The triple therapy group exhibited superior improvements in MIP， MEP， handgrip strength， 6MWD， and lower mMRC scores compared to both standard care and dual therapy groups （P < 0.05）， with additional benefits including lower resting systolic blood pressure versus dual therapy group （P < 0.05） and reduced resting heart rate compared to standard care group （P < 0.05）. Conclusion The combined IMT and EDP significantly enhances respiratory and upper limb muscle strength in CHF patients， effectively improves cardiopulmonary function， alleviates dyspnea， and reduces resting heart rate and blood pressure，thus improving the quality of life.It is worthy of clinical promotion and application.