Gastrointestinal symptoms in gastric cancer patients treated with postoperative chemotherapy are diverse and interconnected, without effective intervention targets. In recent years, network analysis has emerged as a prominent approach to identify intervention targets.

To construct a network of gastrointestinal symptoms in gastric cancer patients treated with postoperative chemotherapy, identify core symptoms and analyze the factors influencing core symptoms, so as to provide a reference for precise symptom management.

Postoperative chemotherapy patients with gastric cancer were selected in the medical oncology and surgical oncology department of four tertiary A-level Chinese medicine hospitals (Jiangsu Provincial Hospital of Traditional Chinese Medicine, Suzhou Hospital of Traditional Chinese Medicine, Wuxi Hospital of Traditional Chinese Medicine, and Xuzhou Hospital of Traditional Chinese Medicine) in South, Central, and North of Jiangsu Province, from March to December 2022 via convenience sampling method, as the study subjects. The MD Anderson Symptom Inventory Gastrointestinal Cancer (MDASI-GI) was used for evaluating gastrointestinal symptoms and their severity among patients receiving postoperative chemotherapy for gastric cancer, as well as assessing the classification of traditional Chinese medicine constitution among patients. The network of gastrointestinal symptoms was constructed using an R package to identify the centrality indexes. The univariate analysis and multiple linear regression analysis were conducted to investigate factors influencing core gastrointestinal symptoms in patients undergoing postoperative chemotherapy for gastric cancer.

A total of 362 electronic questionnaires were collected, 355 were valid, with a valid recovery rate of 98.1%. The highest incidence of gastrointestinal symptoms in patients with postoperative chemotherapy for gastric cancer was lack of appetite (83.1%), taste alteration (81.7%) and nausea (71.0%), and the top three in terms of severity were lack of appetite (2.77 points), taste alteration (2.50 points) and nausea (2.27 points). Network analysis showed that taste alteration had the highest intensity (r_S=1.27) and the highest tight centrality (r_C=1.50) ; vomiting had the highest betweenness centrality (r_B=1.76). The results of multiple linear regression analysis showed that gender (B=0.809, 95%CI=0.319-1.298), smoking history (B=0.706, 95%CI=0.185-1.228) and phlegm-damp constitution (B=1.703, 95%CI=0.538-2.868) were the factors influencing the severity of taste alteration symptoms in patients with gastric cancer after chemotherapy (P<0.05) .

Taste alteration is the core symptom of gastrointestinal symptoms in gastric cancer patients undergoing postoperative chemotherapy. Gender, smoking history, and phlegm-damp constitution are influential factors contributing to taste alteration. Nursing staff can develop intervention strategies based on these core symptoms and their influencing factors to enhance the efficacy of managing gastrointestinal symptoms during chemotherapy in gastric cancer patients.

胃癌术后化疗患者消化道症状多且相互作用，缺乏有效的干预靶点。近年来，网络分析成为研究识别干预靶点的热点。

构建胃癌术后患者化疗期间消化道症状网络，识别核心症状及分析核心症状的影响因素，为精准症状管理提供参考。

采用便利抽样法，选取2022年3—12月江苏省苏南、苏中和苏北的４所三级甲等中医院（江苏省中医院、苏州市中医院、无锡市中医院、徐州市中医院）肿瘤内外科病区的胃癌术后化疗患者作为研究对象。采用安德森症状测评量表胃癌特异性模块评估胃癌术后化疗患者消化道症状严重程度，评估患者的中医体质分类。通过R语言构建消化道症状网络，分析中心性指标；采用单因素分析及多元线性回归分析探讨胃癌术后化疗患者消化道核心症状的影响因素。

本研究共收集电子问卷362份，有效问卷355份，有效回收率为98.1%。胃癌术后化疗患者消化道症状中发生率排名前三的为食欲下降（83.1%）、味觉改变（81.7%）、恶心（71.0%），症状严重程度排名前三为食欲下降（2.77分）、味觉改变（2.50分）、恶心（2.27分）。网络分析显示，味觉改变的强度最大（r_S=1.27），紧密中心性最高（r_C=1.50）；呕吐的中介中心性最大（r_B=1.76）。多元线性回归分析结果显示，性别（B=0.809，95%CI=0.319~1.298）、吸烟史（B=0.706，95%CI=0.185~1.228）及痰湿质（B=1.703，95%CI=0.538~2.868）为胃癌术后化疗患者味觉改变症状严重程度得分的影响因素（P<0.05）。

味觉改变是胃癌术后化疗患者消化道症状群的核心症状，性别、吸烟史及痰湿质为患者味觉改变的影响因素。护理人员可基于核心症状及其影响因素制订干预措施，提高胃癌患者化疗期消化道症状管理效能。