目的　探索胃食管反流病 (GERD)的合理治疗方案。方法　应用 2 4h食管内胆红素与pH监测 ,对 110例有GERD症状的患者检测 2 4h食管内胆汁反流情况及 pH动态变化 ,结合内镜检查来综合分析。结果　根据 2 4h食管内酸和胆红素监测的结果 ,以内镜检查有无黏膜病变而分成两组。内镜检查阳性组 2 5例 ( 2 2 .7% )均有酸 (碱 )病理性反流 ;内镜检查阴性组 85例 ( 77.3 % ) ,其中 73例有酸 (碱 )病理性反流 ,另 12例 ( 10 .9% )反流在生理范围内。内镜检查阳性组与阴性组有反流者相比 ,差异无显著性 (P >0 .0 5 ) ,但内镜检查阳性组和阴性组有反流者与内镜阴性且反流在生理范围者相比均差异有显著性 (P <0 .0 5 )。结论　根据 2 4h食管内监测及内镜检查结果 ,显示 89%GERD均有酸 (碱 )病理性反流 ,酸 (碱 )反流是导致临床症状和食管黏膜损伤的主要攻击因子 ,削弱或消除反流是GERD治疗的关键。GERD易复发 ,需长期维持治疗 ,应特别注意药效、不良反应和经济学问题。 Objective To explore the reasonable treatment of gastroesophageal reflux disease (GERD). Methods 24 h esophageal bilirubin and pH monitoring were applied. 110 patients with GERD symptoms were examined for 24 h esophageal bile reflux and dynamic changes of pH, combined with endoscopic examination for comprehensive analysis. Results According to 24 h esophageal acid and bilirubin monitoring results, with or without endoscopic mucosal lesions were divided into two groups. There were 85 cases (77.3%) of acid (base) pathological reflux in 25 cases (22.7%) of endoscopy positive group, and acid reflux , The other 12 cases (10.9%) reflux in the physiological range. There was no significant difference between the positive group and the negative group (P> 0.05), but the positive group and the negative group of endoscopy were negative and endoscopic negative and reflux in the physiology Range were significantly different (P <0. 05). Conclusion According to 24 h esophageal monitoring and endoscopic findings, 89% of GERD showed acid (base) pathological reflux and acid (base) reflux was the main attack factor leading to clinical symptoms and esophageal mucosal injury, weakening or eliminating Reflux is the key to GERD treatment. GERD easy to relapse, the need for long-term maintenance of treatment, special attention should pay attention to efficacy, adverse reactions and economic issues.