Differential diagnosis: GERD has its obvious clinical characteristics and is mostly distinguished from other esophageal lesions (such as fungal esophagitis, drug esophagitis, etc.) and peptic ulcer, etc. However, with the continuous progress of medical research and the popularization of related medical knowledge (such as the multiple pathogenesis of asthma), we find that the clinical manifestations of many bronchial asthma are very similar to the extraesophageal manifestations of GERD, so that some As a result, some patients are misdiagnosed and mistreated, so here we focus on the mutual differentiation of these two. Bronchial asthma (asthma) is a chronic inflammatory disease of the airways involving a variety of cells, especially mast cells, eosinophils and T lymphocytes, which is associated with airway hyperresponsiveness. This chronic inflammation is associated with airway hyperresponsiveness, which in susceptible individuals can cause recurrent episodes of wheezing, shortness of breath, chest tightness and/or coughing, mostly at night or in the early morning. Reflux-associated asthma is asthma or asthma-like attacks caused by gastroesophageal reflux and is an extraesophageal manifestation of gastroesophageal reflux disease. It is mainly due to the reflux of gastric contents into the laryngopharynx, which irritates the trachea and causes bronchospasm. Identify the difference between the two according to the diagnostic criteria: The diagnostic criteria of bronchial asthma selected in this article are those of asthma in the guidelines for the prevention and treatment of bronchial asthma (definition, diagnosis, treatment and education and management program of bronchial asthma) developed by the Asthma Group of the Chinese Medical Association’s Respiratory Diseases Branch in 2008. 1. Recurrent episodes of wheezing, shortness of breath, chest tightness or cough are mostly associated with exposure to allergens, cold air, physical and chemical stimuli, viral upper respiratory tract infections, and exercise. In contrast, the cough, wheezing and dyspnea of simple reflux asthma are easy to occur after satiety or eating spicy food, mainly occurring at night, easy to occur in the lying position and can be reduced after sitting up, and the attacks are not obviously seasonal. 2, Bronchial asthma attacks can be heard in both lungs with scattered or diffuse, expiratory phase dominated croup and prolonged expiratory phase. In contrast, simple reflux asthma attacks can also be heard as scattered or diffuse croup in both lungs, but mainly as inspiratory difficulty. 3.The above symptoms can be relieved by treatment or by themselves. 4.When the symptoms of episodic cough and wheezing are atypical (e.g. no obvious wheezing or signs), at least one of the following tests should be positive for the diagnosis of bronchial asthma: (1) positive bronchial excitation test or exercise test; (2) positive bronchial diastolic test (FEV1 increased by more than 15%, and the absolute value of FEV1 increased by > 200 ml); (3) intra-day variability or diurnal fluctuation rate of PEF ≥ 20%; while simple reflux asthma will basically not show positive results of the above tests. In summary, it can be seen that because of the different starting mechanisms of the two, they differ in various aspects including definition and diagnosis. If we can take a careful history and improve the relevant examination, then we can clearly distinguish the two.