Objective To explore the distribution characteristics of traditional Chinese emdicine（TCM） syndrome elements in patients with sepsis in internal medicine wards. Methods Patients with sepsis admitted to the internal medicine wards in Guangdong Province Traditional Chinese Medical Hospital from January

2013 to December

2018 were included. General data such as gender

ethnicity

age

and admission diagnosis

as well as patients data including symptoms

syndromes

and the four examinations were collected from the hospital information system. Two resident physicians with more than 3 years experience were in charge of differentiating the syndrome elements. Correlation analysis and cluster analysis were used to explore the distribution law of the high-frequency syndrome elements. Results A total of 4833 sepsis patients in the internal medicine wards were included. The top three symptoms were tiredness

anorexia

and shortness of breath; the tongue manifestation were mostly dusky

pale and red; the coating were mainly greasy

yellow

and white; wiry pulse

slippery pulse

and thready pulse were the most common types. Lung

heart and spleen were mostly involved

with frequency of 56.51%

55.43% and 50.84%

respectively. The top three syndrome elements were qi deficiency pattern

phlegm pattern and fire-heat pattern with the frequency of 79.43%

43.06%

35.30%

respectively. Correlation analysis showed that the support of phlegm pattern-qi deficiency pattern combination was the highest

which was 0.431; and the confidence of the dampness pattern-phlegm pattern-qi deficiency pattern combination was higher

which was 0.952. Cluster analysis suggested that qi deficiency pattern was an independent syndrome element of patients with sepsis. Conclusion Qi deficiency pattern and phlegm pattern are the key syndromes of sepsis in the internal medicine wards

which may progress to bowel excess pattern

blood stasis pattern

and yang deficiency pattern as the disease evolves.