Objective Preventive symptom management was performed on patients with gastric cancer undergoing chemotherapy to reduce the incidence of symptom cluster and the severity of related symptoms. Methods A total of 120 patients with gastric cancer undergoing chemotherapy in oncology department were randomly divided into trial group Ⅰ (n=40), trial group Ⅱ （n=40）, and control group (n=40). All three groups received auricular point acupressure on the basis of routine nursing.The acupoints related to symptom clusters were selected in the trial group Ⅰ, the acupoints related to pain were selected in the trial group Ⅱ, and the sham acupoints were selected in the control group.The three groups were intervened continuously for 1 week.The incidence of pain-fatigue-sleep disturbance symptom cluster and the severity of symptoms in the three groups were observed before and after the intervention. Results After the intervention, the incidence of symptom cluster in the trial group Ⅰ was significantly lower than that in the control group （P＜0.0125）;the pain degree was significantly lower in both trial groups Ⅰ and Ⅱ compared to the control group, while fatigue and sleep scores were significantly lower in trial group Ⅰ compared to both trial group Ⅱ and control group (all P＜0.05). Conclusion The predictive intervention of auricular point acupressure, based on sentinel symptoms in patients with gastric cancer undergoing chemotherapy, can significantly reduce the incidence of pain-fatigue-sleep disturbance symptom cluster and alleviate the severity of symptoms.