Objective We aimed to find the distribution rule of traditional Chinese medicine(TCM) patterns of schizophrenia patients from the result of a large-sample, multicenter, cross-sectional study. Methods From May 2020 to April 2021, we recruited schizophrenic patients in the following 12 subcenters in Beijing: The Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine, The Third Hospital of Chaoyang District, Beijing Anding Hospital of Capital Medical University, Beijing Huilongguan Hospital, Daxing Xinkang Hospital, Changping Hospital of Integrated Chinese and Western Medicine, Shijingshan Mental Health Care Institute, Chuiyangliu Hospital of Tsinghua University, Yanqing District Psychiatric Hospital, Pinggu District Psychiatric Hospital, Guang'anmen Hospital of China Academy of Chinese Medical Sciences, and Dongzhimen Hospital of Beijing University of Chinese Medicine. In total, 4,734 schizophrenic patients(2,529 men and 2,205 women with an average age of 50. 81 years) were included, and their mental symptoms were evaluated using the TCM Pattern Scale, Positive and Negative Syndrome Scale, and the four diagnostic method ( inspection, listening and smelling, inquiry, and palpation and pulse taking). After finishing the Schizophrenic TCM Pattern Observation Form, the distribution of the patients′ TCM patterns was analyzed through the following steps:(Ⅰ) building a network diagram of all symptoms to extract the pattern locations and elements using association rules;(Ⅱ) combining the pattern locations with the pattern elements to form basic pattern, using the method of association rules, and Bayesian network, cluster analysis; and (Ⅲ) summarizing the patterns according to TCM theories and TCM expert consensus, and selecting the same patterns as the patterns of schizophrenia. Results Association rules were used to construct a relationship network diagram of 162 symptoms, and 16 basic TCM pattern were extracted. Among them, (Ⅰ) association rules extracted nine TCM patterns ( phlegm-fire disturbing mind, hyperactivity of heart-liver fire, stagnation of qi and blood stasis, hyperactivity of fire due to yin deficiency, kidney deficiency and liver depression, spirit confused by phlegm, yang deficiency of the spleen and kidney, deficiency of both the heart and spleen, and phlegm-qi stagnation with binding); (Ⅱ) cluster analysis extracted nine patterns (hyperactivity of heart-liver fire, phlegm fire burning yin, stagnation of qi and blood stasis, yin deficiency and blood insufficiency, yang deficiency of the spleen and kidney, stagnation of phlegmdampness, deficiency of both the heart and spleen, deficiency of kidney qi, and deficiency of bile qi); and (Ⅲ) the Bayesian network extracted 11 patterns(phlegm-fire disturbing mind, hyperactivity of heartliver fire, hyperactivity of fire due to yin deficiency, stagnation of qi and blood stasis, intermingled phlegm and heat, kidney deficiency and liver depression, spirit confused by phlegm, deficiency of both the spleen and kidney, deficiency of both the heart and spleen, disharmony between the heart and kidney, and liver-kidney deficiency). Finally, eight common patterns were summarized, including phlegm-fire disturbing mind, hyperactivity of heart-liver fire, stagnation of qi and blood stasis, hyperactivity of fire due to yin deficiency, spirit confused by phlegm, deficiency of both the heart and spleen, yang deficiency of the spleen and kidney, and kidney deficiency and liver depression. The clinical features of schizophrenic patients included negative symptoms (2,893 cases, 61. 11%) and positive symptoms (1,841 cases, 38. 89%). The former belongs to the TCM “ epilepsy syndrome” category, and the patterns of yang deficiency of the spleen and kidney(22. 94%), spirit confused by phlegm(17. 79%), deficiency of both the heart and spleen(13. 98%), and kidney deficiency and liver depression(6. 40%) are involved. The latter belongs to the TCM “manic psychosis syndrome” category, and the patterns of phlegm-fire disturbing mind(12. 63%), stagnation of qi and blood stasis(11. 03%), hyperactivity of fire due to yin deficiency(10. 25%), and hyperactivity of heart-liver fire(4. 99%) are involved. Conclusion This study may provide a reliable basis for forming plans for TCM diagnosis and treatment of schizophrenia, which can be guided by the 8 TCM patterns from 4. 734 patients. [ABSTRACT FROM AUTHOR]