Thread-Embedding Acupuncture as an Adjunct to Proton Pump Inhibitor Therapy for Gastroesophageal Reflux Disease

Inclusion Criteria: * Aged 18 to 60 years. * Diagnosed with gastroesophageal reflux disease (GERD) with a GerdQ score ≥8 and typical heartburn and/or regurgitation occurring at least 2 days per week, and considered eligible for proton pump inhibitor therapy according to the ACG 2013 guideline. * Meets the diagnostic criteria for Liver-Stomach Heat Stagnation Syndrome according to the 2017 expert consensus on traditional medicine syndrome differentiation for GERD. * No previous diagnosis of GERD within the past 8 weeks. * Voluntarily agrees to participate in the study and provides written informed consent. Exclusion Criteria: * Presence of alarm symptoms, including dysphagia, odynophagia, palpable lymph nodes or mass, unintentional weight loss, family history of gastrointestinal malignancy, gastrointestinal bleeding, anemia, or persistent nausea/vomiting. * Structural gastrointestinal disease confirmed by endoscopy, including esophageal malignancy or other significant organic lesions. * Current use of medications that may influence GERD assessment or treatment, including glucocorticoids, NSAIDs, bisphosphonates, prostaglandins, oral contraceptives, antifungal agents, or sedative medications. * Use of proton pump inhibitors, H2-receptor antagonists, or prokinetic agents within the previous 14 days. * History of hypersensitivity to proton pump inhibitors or absorbable catgut/thread material. * Skin inflammation, infection, or other dermatologic disease at or around the intended thread-embedding sites. * Current pregnancy or breastfeeding. * Currently participating in another interventional clinical study.