Additionally, it strengthens the intestinal mucosal barrier by modulating the intestinal flora, reduces inflammatory cytokines such as IL-6, TNF-α, and IL-1β, alleviates esophageal mucosal immune inflammation, and improves esophageal visceral hypersensitivity.[16, 17, 18, 19, 20] This study aims to further validate the clinical efficacy of HTD in the treatment of patients with NERD. Here, TNF is linked to inflammation.