Gastroesophageal reflux disease (GERD) is a disease in which stomach contents flow back into the esophagus, causing uncomfortable symptoms and/or complications. It is often divided into three types: non-erosive reflux disease (NERD), reflux esophagitis (EE) and Barrett’s esophagus (BE), with NERD being the most common, accounting for 65%-75% of cases. Typical symptoms are heartburn and reflux, but also include epigastric pain, chest pain, belching, bloating, epigastric discomfort, foreign body sensation in the throat, difficulty swallowing, and extra-esophageal symptoms such as chronic cough, pharyngitis, and asthma. The prevalence of GERD in Beijing and Shanghai in China is 5.77% [3], and the incidence of this disease has increased significantly in recent years. Modern medicine believes that GERD is mainly caused by the weakened anti-reflux defense mechanism and the enhanced attack of reflux on the esophageal mucosa. The combination of acid suppression, gastrointestinal stimulants and mucosal protectors can rapidly relieve the symptoms, but it is easy to relapse after stopping the medication. In Chinese medicine, this disease belongs to the category of “acid vomiting” and “esophageal disease”, which is caused by disorder of diet, emotional and mental disorders, overexertion and deficiency of the spleen and stomach, resulting in disharmony of the ascending and descending functions of the spleen and stomach and rebellion of the stomach qi. Professor Wang started with acupuncture in regulating the qi of the middle jiao, which has remarkable efficacy, and its application is introduced as follows, hoping to share with fellow practitioners. 1. Acupuncture prescription 1.1 Main acupoints “old ten needles” [6] (epigastric, middle epigastric, hypogastric, qihai, tianshu double, sansili double, nei guan double), shimen double, zhangmen double, abdominal knot double, scalp acupuncture stomach area double (pupil straight up into the hair traces), yingxiang double. 1.2 Matching points Reflux disease is often accompanied by a variety of symptoms, matching points with the symptoms (evidence) to add or subtract. For severe insomnia, add the AnSleep point, ShenMen, BaiHui, and SiShenCong to calm the mind; for itchy throat and cough, add TianTu, RenYing, ShouZe, and FengLong to regulate Qi, resolve phlegm, and stop cough. 1.3 Acupuncture operation 1.3.1 1.5-inch milli-needle: the needle tips of the upper, middle and lower cavity points are diagonally stabbed downward into 1-1.5 inches, with the degree of Qi; Tianshu and Qihai are straight stabbed 0.5-1.5 inches, with no pain as good; the period and Zhangmen, the needle tips are gently diagonally stabbed 0.5-1.5 inches to both sides; the Nei Guan points are diagonally stabbed 0.5-1 inch, with the needle tips on the left side in the direction of the heart and the right side in the direction of the centrifugal, with local soreness as good; the scalp Needle point needle body and scalp at an angle of 15 °, into the needle 0.5-1 inch, sink tight for the degree; Yingxiang point slightly upward oblique stab or flat stab 0.5-1 inch, or add the upper Yingxiang point downward oblique stab. 1.3.2 4-inch mango needle: mango needle stabbed obliquely into the foot Sanli and abdominal node points 2-4 inches, the foot Sanli needle stabbing direction downward, bilateral abdominal node points stabbed obliquely in the direction of 45 ° downward, to obtain the degree of Qi. 1.4 Meaning of the formula This prescription is composed by adding and subtracting from the “Old Ten Needles”. The “Old Ten Needles” [6] is an acupuncture prescription summarized by Professor Wang Leting from many years of practice in treating gastrointestinal diseases. Zhongguancun, the point of the collection of the stomach, and the meeting of the internal organs of the eight meeting points; foot Sanli, the combined point of the stomach meridian; the three epigastric, middle and lower epigastric, with the effect of local adjustment of the stomach and internal organs; Tianshu, the collection point of the large intestine; Qihai, the place where the innate qi converges; Neiguan, the meeting point of the eight channels, which is connected to the Ren channel; Zhimen and Zhangmen, the collection points of the liver and spleen, where the qi of the internal organs meridians converge; the stomach area, located on the scalp, should be in the stomach and internal organs; Yingxiang, Professor Gao Lishan’s “The abdominal knot, a key point of the spleen meridian, is penetrated by mango needles to regulate the qi and blood of the spleen, stomach, and kidney meridians; all the points work together to dredge the liver and stomach, regulate the middle and strengthen the spleen, and raise the clear and lower the turbidity. 1.5 Prescription features 1.5.1 Holistic view of acupuncture points – the three parts of heaven, man and earth. The Spleen and Stomach are the source of Qi and blood biochemistry; internal injury to the Spleen and Stomach can cause all kinds of diseases, and Zhang Jinyue’s “On the Spleen and Stomach” believes that “the Spleen and Stomach is the source of the internal organs, so it is not as far up as the head and down as far as the feet. ……”, indicating the wide range of diseases and changes caused by the Spleen and Stomach. Therefore, the points should be taken as a square formation (Tian Ren Di Three Part Formation, Navel Thursday Point + Recruiting Point + Mango Needle Penetrating Point Formation), so that the left and right sides are proportional, the top and bottom correspond, and the main and auxiliary sides are compatible, so that the whole body can communicate with the qi and the four sides can be irrigated. 1.5.2 Holistic view of qi regulation – Qi dispersal in the middle jiao and qi transportation in the extremities. Mr. Wang believes that the qi in the middle jiao is easily knotted and reversible, so the treatment is to disperse and descend, and to regulate the qi of the whole body through the direction, sequence and depth of acupuncture. The point is located in the hypochondrium and belongs to Shaoyang. Shaoyang Sanjiao is the way of Qi, fire and water, and is the pivot of Qi flow, so the needle tip should be directed outward to release the evil Qi from Shaoyang; Sanjiao, abdominal knot and foot Sanli are located in the local stomach and epigastric region or stomach meridian, so the needle tip should be directed downward to lower the rebellious Qi of the stomach. Liver qi rises on the left and lung qi descends on the right, in accordance with the “left ascending, right descending” rule of operation of the whole body qi, so the left side of Neiguan is stabbed obliquely in the heart, and the right side of Neiguan is stabbed obliquely in the centrifugal direction. 1.5.3 Make good use of the points. Clinically, this disease is most commonly observed in patients with liver-stomach heat and liver-stomach disharmony, and there is often pressure pain at the points, especially at the stage gate and zhangmen points. Mr. Wang started with the points of the main points, dredging the liver and stomach, and regulating the middle jiao, with remarkable efficacy after acupuncture. Therefore, clinical evidence (symptoms) often adds and subtracts from the points of the central cavity, zhangmen, shimen, sun and moon, and jingmen. 1.5.4 Qiangxian acupuncture treatment. Gastroesophageal reflux has a long duration and is prone to recurrence. Mango acupuncture, which penetrates multiple points with one needle, is effective in treating this disease. “One needle with two points is rare in the world” “It is better to lose its point than its meridian”. In clinical practice, Wang often uses 4-inch mango needles to penetrate the abdominal nodes in an oblique 45° direction to regulate the qi and blood of the spleen, stomach and kidney meridians; to penetrate the foot three li downward, slightly toward the tibia, to regulate the qi and blood of the stomach meridian and its surrounding yang meridians and to lower rebellious qi; to penetrate the Yinlingquan point downward to regulate the qi and blood of the spleen meridian and its surrounding yin meridians; to penetrate the foot five li downward to regulate the liver qi and to regulate the qi and blood of the liver meridian; and to penetrate the Qi point downward to regulate the kidney meridian. Qi and Blood. The choice is made clinically according to the evidence (symptoms). 1.5.5 Focus on acupuncture techniques. Ling Shu q nine needles twelve original: “thorn of the want, gas to and effective, the effect of the letter, if the wind blows clouds, clear as if to see the sky, thorn way is complete. Acupuncture treatment with or without qi, is the key to achieving curative effect, so acupuncture technique in the treatment of reflux disease is particularly important. Wang emphasized the finger force, clinical observation of the patient’s feeling of Qi is mostly soreness, numbness and swelling, there are meridians, slowly and gently conduct, such as water ripples spread around, to the disease, not a strong feeling, the patient feels relaxed and comfortable after the treatment. 2.1 Operation: After conventional acupuncture, use a series of milli-needles (5-7), burned red on an alcohol lamp, to cupping in the abdomen (Zhonggui, Liangmen, Zhimen, Zhangmen, Tianshu, etc.), lower limbs (inner thighs, calves), etc. After conventional sterilization, save the bleeding cupping, making the holes bleed slightly and releasing a small amount of blood. The electro-acupuncture apparatus is used, and electrodes are often placed on the abdominal nodes and the foot three li points. The sacred lamp irradiates the stomach and epigastric region. 2.2 Formula: GERD symptoms are diverse, only the ordinary acupuncture treatment, because of its insufficient force, sometimes difficult to work, on the basis of conventional acupuncture with acupuncture cupping to regulate the middle jiao, to give the evil to the way out, the efficacy multiplied. The main points of the stomach, liver, spleen, large intestine and other internal organs are the collection points of the stomach, liver, spleen and large intestine, and the collection points are where the qi of the internal organs converge, so acupuncture and cupping regulate the middle jiao, so that the qi of the internal organs can be regulated and the liver, spleen, stomach and intestine can be harmonized; the inner part of the lower extremity is dominated by the three yin meridians of the foot, so saving acupuncture and bleeding cupping makes the holes bleed slightly and releases a small amount of blood to stimulate the meridian qi, adjust yin and yang [7], and give the evil a way out because of the downward movement of the rebellious qi. It is also combined with electroacupuncture and divine light to improve the therapeutic effect of acupuncture. 3, prevention and conditioning diet, the patient is advised to eat more light and nutritious easily digestible food, more fresh vegetables and fruits, no spicy, cold and greasy food, no smoking, alcohol; life, regular living, sleep with the head of the bed elevated (about 15-20 cm), after meals, let the patient in an upright position or after meals for a walk; mental, keep a relaxed mood, guide the patient to establish confidence in the cure; medication, avoid taking can reduce Avoid taking drugs that can reduce the tone of the lower esophageal sphincter, such as atropine, aminophylline, cardiac pain, valium, etc.