To systematically evaluate the distribution characteristics of traditional Chinese medicine (TCM) syndromes in adult influenza patients and to provide a basis for the TCM syndrome differentiation of influenza. The CNKI, CBM, Wanfang, VIP, PubMed, Embase, Cochrane Library databases were searched to collect cross-sectional studies on the distribution pattern of TCM syndromes in adult patients with influenza. The risk of bias assessment tool for cross-sectional studies developed by the Joanna Briggs Institute (JBI) evidence-based health care center was used to evaluate the literature quality, and the Stata 15.1 software was used to conduct a Meta-analysis of the pooled effect sizes of the included studies. A total of 11 studies with 4 367 influenza patients were included. Quality assessment results of JBI showed that the risk bias was higher in the sample size calculation, and the description of sampling modalities and response rate was unclear. There were 17 influenza syndromes after specification, and a single group rate Meta-analysis was performed of the syndromes with ≥ 50 incident cases showed that there were 9 syndromes with an incidence ≥ 10% and statistical significance, the top 5 syndromes were syndrome of wind and heat invading the defense [n = 1 583, RATE = 34.3%, 95% confidence interval (95%CI) was 22.2%-46.3%], syndrome of exterior cold and interior heat (n = 1 122, RATE = 36.1%, 95%CI was 21.2%-51.1%), syndrome of wind-cold fettering the exterior (n = 860, RATE = 19.4%, 95%CI was 10.7%-28.0%), syndrome of heat and toxin in the lung (n = 217, RATE = 17.1%, 95%CI was 9.1%-25.0%), and syndrome of disease involving both defense phase and qi phase (n = 184, RATE = 38.8%, 95%CI was 14.2%-63.5%). The results of the subgroup analysis in different geographical regions showed that the frequency of distribution of syndrome of wind and heat invading the defense and heat and toxin in the lung was higher in the South (RATE: 36.5%, 18.6%) than in the North (RATE: 30.9%, 15.4%), and the frequency of distribution of syndrome of wind-cold fettering the exterior and exterior cold and interior heat in the North (RATE: 23.8%, 40.1%) was higher than that in the South (RATE: 15.7%, 32.3%). There are 9 common TCM syndromes of influenza, including wind and heat invading the defense syndrome, exterior cold and interior heat syndrome, wind-cold fettering the exterior syndrome, heat and toxin in the lung syndrome, disease involving both defense phase and qi phase syndrome, wind and heat complicated by dampnessinvading the surface syndrome, wind and cold complicated by dampnessinvading the surface syndrome, defense phase syndrome and dampness and heatinvading the surface syndrome, which can provide a reference for the TCM syndrome differentiation and treatment of influenza.
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