There are many causes of chest pain, common diseases include heart disease (coronary angina, myocardial infarction), pneumonia, lung cancer, tuberculosis, pulmonary embolism, costochondritis, intercostal neuralgia, herpes zoster and many other diseases, in fact, with the improvement of living standards and weight gain, a more common disease that can cause anterior chest discomfort and pain is gastroesophageal reflux disease, which has a variety of manifestations, some manifest as Some present with burning pain from the pharynx straight to the heart, some with back pain, others with toothache, sore throat, pain on both sides of the anterior chest, and others can have choking coughs, allergic rhinitis, and even asthma attacks, many so severe that they need to see the emergency room again and again. Many cardiologists have difficulty distinguishing whether the chest pain is cardiogenic or non-cardiogenic, because it responds well to nitroglycerin, an effective drug for angina, and some patients have been “misdiagnosed and mistreated” for many years. A few years ago, a friend’s mother had a sudden onset of chest pain at night and was examined by an electrocardiogram at a health center: mild st changes, myocardial ischemia was considered, and the symptoms were alleviated after the sedation of salvia. Her son was worried about the risk of the test and the fact that he could not find a doctor after the test, so he wanted to use Chinese herbal medicine to reduce the symptoms and decide whether to do coronary photography after the holiday. The patient is now 84 years old and can take care of himself completely. Another 73-year-old man from Hebei had unexplained right-sided chest pain for several years, and could not lie down or sleep during chest pain episodes, and could only walk on the floor continuously, sometimes for several hours to slowly reduce. The diagnosis of severe gastroesophageal reflux disease was made by dynamic pH and impedance measurements. This elderly man had gastroesophageal reflux 113 times in 24 hours, the longest reflux was 53 minutes, and the combined reflux time was 397 minutes. The lowest esophageal pH was close to 0 (normal esophageal pH is 7.0), which means that for almost 6 hours a day, the high intensity acid from the reflux continued to soak and irritate the esophagus, causing inflammation, ulceration and nerve irritation in the esophagus, resulting in anterior chest and back pain. This pain is indistinguishable from a heart attack and is the real cause of this elderly man’s frequent chest pains. There was also a 36-year-old female patient who suffered from pharyngitis for a long time and felt chest discomfort from time to time, which could not be cured for a long time. After examination, the pH of the esophagus was found to be normal, but impedance measurements revealed that the patient had 70 refluxes, which were basically weak acid refluxes, and nearly 30% of the reflux range reached the pharynx. The combined esophageal pH and impedance measurement is the gold standard for the diagnosis of GERD, which can distinguish whether there is reflux; when the reflux occurs; whether the reflux is acidic, weakly acidic or non-acidic (alkaline); whether the reflux is standing or lying down; whether the reflux is related to eating and many other factors, and the appropriate treatment for the time and factors of reflux will naturally achieve better results. A middle-aged man, fat, recently started physical exercise, and started brisk walking one hour after meals every day, but soon developed chest pain, which was unbearable and could be gradually reduced by stopping exercise. However, esophageal impedance showed that a large amount of gastroesophageal reflux appeared during meal and 1 hour after meal, and the reflux decreased significantly 2 hours after meal, and the patient started walking fast 1 hour after meal when a large amount of reflux appeared, at which time chest pain appeared, and it was evaluated that the probability of joint symptoms reached more than 90%, so it was judged that the chest pain was related to reflux; then the patient was carefully asked about his eating habits, and he was the kind of person who eats a lot and eats very fast, so it was judged that the stomach content was too much after a large amount of meal and had not been After advising the patient to reduce the amount of food eaten and postpone physical exercise for one hour, together with gastric motivational drugs and Chinese herbal medicine to regulate and lower gas, the patient had no more chest pains. Gastroesophageal reflux disease is common in the elderly and is generally thought to be related to the clearing function of the esophageal wall, the tension of the esophageal fissure and the lack of gastric emptying ability, but in the last decade or so, the incidence has increased significantly and the age of onset has decreased, especially in obese people and those who like to eat fatty, sweet and greasy food. Reducing weight and changing lifestyle are the basis of treatment for gastroesophageal reflux disease. Although the symptoms of GERD are complex and varied and can appear in multiple systems, there are actually traces of it. One is that drinking water during an attack can reduce the symptoms, and it can also be treated with a trial of lazaroid drugs such as omeprazole. If the reflux is acidic reflux usually achieves efficacy within a week after the drug is administered, and if it is weak acid reflux or acid-free reflux, or if the timing of the drug administration is not right, the efficacy is not too satisfactory. The combined method of esophageal pH and impedance measurement is relatively simple, only a diameter electrode as thick as a thin spaghetti is inserted into the esophagus through the nasal cavity and fixed 5 cm above the lower esophageal sphincter, and the result can be measured continuously for 24 hours. It is a simple and completely acceptable method to check GERD.