In clinical work, we often encounter patients who report heartburn, acid reflux, and uncomfortable pain behind the sternum, along with symptoms such as throat discomfort, warmth, regurgitation, abdominal distension, and even extraesophageal symptoms such as cough and asthma, and should consider whether they have gastroesophageal reflux disease (GERD). Gastroesophageal reflux disease refers to symptoms such as heartburn and acid reflux caused by the regurgitation of gastroduodenal contents into the esophagus, and can lead to esophagitis and damage to tissues outside the esophagus such as the pharynx, larynx, and airway. Gastroesophageal reflux disease is a common gastrointestinal disease, with a prevalence of 10% to 20% in Western countries. The prevalence in China is increasing year by year, about 5% to 10%. The disease is caused by a variety of factors, resulting in a reduction in the anti-reflux defense mechanism of the esophageal mucosa and the destruction of the esophageal mucosa by refluxed material. Long-term alcohol consumption, smoking, strong tea and psychological disorders can damage the esophageal mucosal barrier and prevent the attack of hydrochloric acid and pepsin, etc. On the basis of the decreased anti-reflux effect of the esophagus, the reflux of gastroduodenal contents (gastric acid and pepsin) into the esophagus can cause damage to the esophageal mucosa. In patients with gastroesophageal reflux symptoms, endoscopic examination without manifestations of reflux esophagitis is called non-erosive reflux disease; those with inflammatory changes of esophageal mucosa visible under endoscopy are called erosive esophagitis; Barrett’s esophagus (Barrett) is diagnosed when endoscopic examination reveals significant columnar epithelial hyperplasia in the distal esophagus and esophageal squamous epithelium is replaced by columnar epithelium. Its incidence of adenocarcinoma is 30 to 50 times higher than normal, and it is the main precancerous lesion of esophageal adenocarcinoma. Esophagoscopy can directly observe the morphology, extent and degree of esophageal mucosal lesions, and biopsies can also be taken for pathological examination. Other auxiliary examinations include 24-hour esophageal pH measurement, barium swallow X-ray, esophageal manometry, etc. In terms of treatment, western medicine is mainly used to inhibit gastric acid, improve motility, and protect the mucosa. When reflux esophagitis is treated with standard doses of proton pump inhibitors (PPI) such as omeprazole, lansoprazole and pantoprazole for 8 weeks and non-erosive GERD for 4 weeks and still have GERD symptoms, it is called refractory GERD. Chinese medicine has advantages in treating refractory GERD. According to Chinese medicine, the esophagus belongs to the stomach and the spleen, and the spleen and the stomach, one organ and one internal organ, one ascending and one descending, one nourishing and one transforming, are mutually restrained and coordinated. The two together perform the functions of receiving, transporting and nourishing the muscles of the water and grain essence of the latter day. Spleen deficiency and qi stagnation, and imbalance of elevation are the main pathogenesis of gastroesophageal reflux disease. Because the spleen and stomach are the hub of qi elevation, “the spleen should ascend to be healthy, the stomach should descend to be harmonious”, the elevation of each other, the qi will be smooth; the elevation is out of harmony, the qi is stagnant, you will see chest and epigastric pain, swallowing acid and noisy and other symptoms. In our clinical practice, we adopt the method of regulating the spleen and stomach, ascending the clear and descending the turbid, and use the method of tonifying Zhong Yi Qi Tang and combined with the method of lifting and descending San to form the tonifying and ascending drink, achieving satisfactory results. This formula, combined with Sheng Qi Tang, is a basic formula that can help to improve the strength of the esophageal mucous membrane by “elevating the clear yang in yang and lowering the cloudy yin in yin”, so as to accelerate gastric emptying and reduce the damage to the esophageal mucous membrane caused by reflux, and at the same time, it can help to improve the symptoms, reduce recurrence, prevent pre-cancerous lesions and other complications, and fundamentally cure GERD by combining the methods of dredging the liver and regulating qi, activating blood circulation, and so on. In addition In addition, we should pay attention to prevention and regimen, do the following: 1, mood regulation GERD patients often have a certain degree of liver qi depression, so it is particularly important to maintain a relaxed mood, it is appropriate to ease the patient, cultivate a positive and optimistic attitude, timely adjustment of mood, in order to facilitate early recovery from the disease. 2, diet taboos (1) for obese patients, to control the diet, balanced nutrition, as soon as possible to reduce weight. (2) Reduce the intake of high-fat meals. (3) Avoid eating coffee, chocolate, mint. (4) Abstain from smoking and alcohol. Long-term high intake of alcohol. (5) Avoid eating too cold, too hot and sweet, sour, spicy and other irritating foods to prevent worsening of pain symptoms and leading to recurrence of the disease. Avoid taking drugs that can lower the tone of the lower esophageal sphincter, such as anticholinergics, dopamine agonists, calcium channel blockers, etc. (1) Since reflux tends to occur at night, the head of the bed should be elevated 15-500px during sleep. (2) Do not eat before bedtime, and the interval between dinner and sleep should be stretched to no less than 3 hours to reduce food stimulation of acid secretion at night. (3) Put the patient in an upright position after each meal or take a walk after the meal to promote food evacuation with the help of gravity and avoid strenuous exercise.