This paper introduces Zhu Shengliang’s experience in the treatment of refractory gastroesophageal reflux disease. It is considered that the difficulty of syndrome differentiation of the refractory gastroesophageal reflux disease lies in involving multiple Zang-fu organs, forming endogenous pathogens easily during the course of the disease, and the pathogenesis with similar symptoms and different natures often exist in combination. Based on the main contradictions, the paper proposes the dialectical thinking of distinguishing the characteristics of the pathogenesis of Zang-fu organs and the similar Zang-fu organs, clarifying the weight of deficiency and excess, and establishes therapeutic principles and makes up prescriptions on the basis of syndrome differentiation of Zang-fu organs combined with syndrome differentiation of qi, blood and body fluid. And two proven cases are presented.