TCM patterns and brain–gut axis function in functional gastrointestinal disorders: A cross-sectional study of symptom and psychological comorbidityprofiles

Objective To investigate the association between traditional Chinese medicine (TCM) patterns and brain–gut axis function in patients with functional gastrointestinal disorders (FGIDs), with a focus on gastrointestinal symptoms (the gut end) and psychological status (the brain end). Methods We enrolled 746 patients with FGIDs diagnosed according to the Rome IV criteria and consolidated their TCM patterns into six standardized categories. Gastrointestinal symptoms were assessed using the Gastrointestinal Symptom Rating Scale (GSRS), and psychological status was assessed using standardized scales. Analyses included Kruskal-Wallis tests, Dunn’s pairwise comparisons, Spearman’s rank correlations, and network analysis. Results GSRS total scores differed significantly across TCM patterns ( P < .001), with a severity gradient from dampness-heat (most severe) to spleen deficiency (least severe). All five GSRS dimensions showed significant differences across patterns (all P < .05), whereas scores on the psychological scales did not ( P > .05). TCM patterns were weakly correlated with GSRS scores ( r = 0.105, P < .001) but showed only negligible correlations with scores on the psychological scales (| r | < 0.07), with only the RRS reaching nominal statistical significance ( r = 0.068, P = .031). Network analysis showed weak connections between TCM patterns and only the GSRS and Ruminative Response Scale (RRS). Conclusions TCM patterns in FGIDs effectively differentiate gastrointestinal symptom severity but show weak associations with psychological status. Clinically, pattern differentiation should prioritize gastrointestinal symptoms, while psychological status requires independent assessment.