Distribution of Traditional Chinese Medicine Pattern Elements in Patients with Gastric Cancer: A Cross-Sectional...

Gastric cancer remains a major cause of morbidity and mortality worldwide, with a particularly high burden in China. Traditional Chinese Medicine (TCM) emphasizes holistic regulation and syndrome differentiation, yet reproducible methods for quantifying syndrome elements in gastric cancer are limited. We conducted a cross-sectional study of 60 patients at Wuxi Second Traditional Chinese Medicine Hospital (December 2022-March 2024) and present a standardized, reproducible protocol for syndrome-element evaluation. Demographics, medical history, and TCM diagnostic information were captured with a standardized case-report form; syndrome elements were identified using a weighted scoring system with dual-expert adjudication. Analysis followed a prespecified multivariate pipeline-two-stage H-K clustering (hierarchical Ward.D2 to suggest k followed by k-means refinement), correlation-network mapping, and principal component analysis. The most frequent elements were qi stagnation, qi deficiency, blood stasis, spleen deficiency, and dampness; strong associations were observed between qi stagnation and blood stasis and between qi deficiency and blood stasis, with additional links involving dampness/phlegm. Principal component analysis indicated that a small set of elements accounted for the largest share of between-patient variation, supporting clinically meaningful stratification. This protocol operationalizes TCM syndrome-element assessment into measurable steps with shareable forms and code, enhancing objectivity and reproducibility and providing a methodological basis for clinical decision-making and multicenter validation. The framework is adaptable to other malignancies, facilitating broader integration of TCM within evidence-based oncology.