Yang et al.: Efficacy of Vonoprazan Fumarate TabletsTo evaluate the efficacy of vonoprazan fumarate tablets in refractory reflux esophagitis and to provide new insights into the clinical management of refractory reflux esophagitis. A total of 60 refractory reflux esophagitis E patients meeting the inclusion criteria were recruited and assigned via random number table method to receive either conventional treatments (control group) or vonoprazan fumarate plus conventional treatments (treatment group), with 30 cases in each group. Traditional Chinese medicine decoction was administered for adjuvant therapy. Outcome measures included clinical symptom score, gastroesophageal reflux disease healthrelated quality of life scores, esophageal mucosal damage, serum inflammatory factors, serum calcitonin gene related peptide, 5-hydroxytryptamine levels and relapse. Vonoprazan fumarate resulted in milder esophageal mucosal damage and symptoms, and a lower incidence of recurrence vs. conventional treatment alone (p<0.05). Patients with vonoprazan fumarate showed higher quality of life and lower inflammatory factor levels vs. those without (p<0.05). No documented safety events were found during the administration of vonoprazan fumarate. Vonoprazan fumarate tablets are effective in acid suppression, reducing serum calcitonin gene related peptide and 5-hydroxytryptamine levels in refractory reflux esophagitis patients, alleviating the inflammatory response and promoting esophageal mucosal healing with a high safety profile. Vonoprazan fumarate tablets supplemented with traditional Chinese medicine decoction offers a viable option for the treatment of refractory reflux esophagitis. Further studies are required prior to clinical promotion.