(Disclaimer: This article is for general use only. To protect patient privacy, the following information has been processed) Abstract: The patient had recurrent gastric distension and fullness for more than 1 year, aggravated for 1 month, accompanied by nighttime acid reflux, noisy, good food and easy hunger, irritable, dry mouth, bitterness, bowel movements, poor sleep, red tongue, yellowish greasy coating, and slow pulse. In combination with Chinese medicine, we considered the evidence of gangrene, which is a mixture of cold and heat, and used Chinese herbal medicine to treat the symptoms, so as to calm the cold and heat, eliminate the gangrene and disperse the nodules. Basic information】Female, 50 years old 【Disease type】Plumpiness 【Visiting hospital】The First Affiliated Hospital of Nanchang University 【Visiting time】May 2021 【Treatment plan】Therapeutic treatment with traditional Chinese medicine (Radix Panaxiae, Radix Scutellariae, Radix Scutellariae, Radix Glycyrrhizae, Radix Ginger, Radix prunus ginseng, Houpu, Citrus aurantium, Dandelion, Cuttlebone, Corrugated seed, Calcined oyster) + Traditional Chinese medicine soup (Radix Panaxiae diarrhea heart soup formula in granules) 【Treatment period】1 month Outpatient treatment, follow-up for six months 【Treatment effect】Noisy, acid reflux improved I. Initial interview Patient Ms. Zou, 50 years old, visited the clinic in May 2021, upon inquiry, the patient had recurrent gastric distension and discomfort for more than 1 year, aggravated for 1 month, the patient had a history of chronic gastritis for more than 10 years, recurrent gastric distension and discomfort, repeated gastroscopy was non-atrophic gastritis with intestinal epithelial metaplasia. In the past 1 month, gastric distension and fullness were significantly aggravated, especially at night, with noisy and heartburn, which was slightly relieved after eating, and was not significantly relieved by self-administration of omeprazole enteric capsules. Gastroscopic pathology showed moderate chronic non-atrophic gastritis of the gastric sinus and mild intestinal epithelial metaplasia, and the Western diagnosis was gastroesophageal reflux disease and chronic gastritis, and the Chinese diagnosis was gangrenous evidence of cold and heat. After identification, the patient was found to be suffering from cold-heat mismatch, and the treatment method chosen was to calm down the cold and heat, and eliminate the lumps and disperse the knots. The treatment method is to calm down the cold and heat and dispel the lumpiness. The patient came back to the clinic in 1 week and reported that the stomach distention and stuffiness basically disappeared, the bitterness and noisy symptoms still existed, acid reflux was obvious when fasting, slightly relieved after eating, sleep was improved, and the yellow greasy moss had melted. Therefore, cuttlebone, corrugated oyster and calcined oyster were added on the front. After 1 week, the patient’s third examination, the stomach acid reflux and noisy apparently alleviated, food intake improved, stool formed, night sleep, mental improvement, but intestinal tinnitus existed, the tongue is red, thin yellow moss, pulse thin and slightly string, continue the front, changed to the Hanxia Diarrhea Heart Tang formula granules to consolidate the effect. Third, the treatment effect 2 weeks after the follow-up, the patient’s spirit improved significantly, acid reflux has stopped, slightly burning in the stomach and epigastric when eating carelessly, normal stool, sleep well at night, continue to take the front 1 month, observe six months without recurrence. In the formula, Huang Lian, Scutellaria, Rhubarb, Dandelion to clear the fire of the liver and stomach, less adjuvant pungent hot dry ginger to warm the middle and lower the rebellious, Han Xia and stomach rebellious, thick Park, Jie Shi to regulate the Qi and lowering, Prince Ginseng to strengthen the solution to benefit the stomach, through the middle and tonic to protect the stomach Qi. Large doses of cuttlebone, corrugated oyster and calcined oyster are used to control acid and protect the stomach. The whole formula achieves the ideal therapeutic effect in the harmonization, circulation and subduing embodied by the balanced regulation of heat and cold. I am glad that the patient has not relapsed after several months of careful treatment, the precautions are the following three points: 1, the occurrence of the disease and changes in the condition are closely related to diet, eat too acid, spicy, sweet, salty, and greasy food, wine, coffee, strong tea, chocolate and other foods can aggravate the disease, must be strictly controlled; 2, the occurrence of the disease and the condition, mental and emotional relationship, maintain a good mood is more important. It is important to maintain a good mood. Patients should pay attention to de-stressing the liver and regulating qi and harmonizing the liver and spleen; 3. Patients need to be treated in stages, gradually decreasing western and traditional Chinese medicines according to changes in their conditions to consolidate the efficacy and prevent relapse. In this case, the patient suffered from gastroesophageal reflux disease, which could not be cured repeatedly, and the pain was unbearable, seriously affecting work and life. This disease is ineffective with western medicine proton pump inhibitors, and it is a persistent disease. At the first diagnosis, there are often a lot of symptoms, mixed with hot and cold, deficiency and reality, but there is no special abnormality in the examination. The clinical essence of TCM is to identify and treat the symptoms, grasp the main pathogenesis, i.e. liver depression and spleen deficiency, stomach failure and lowering, and adopt the harmonization method to reconcile the internal organs, harmonize the qi mechanism, and balance heat and cold. The disease is prone to recurrence, usually due to eating cold and injuring the spleen and Yang, or recurrence due to sudden discontinuation of medication after taking effect, so patients should gradually reduce medication and pay attention to stomach maintenance to avoid recurrence.