Objective:To observe the clinical efficacy of “Qingxia Jieyi Decoction” by nasal feeding and enema therapy with western medicine in treating severe acute pancreatitis (SAP)  Methods:Fifty-six cases with SAP were randomized into two groups:control group in which 27 cases were treated by conventional western therapy and treatment group in which 29 cases were treated by combination of the western medicine and “Qingxia Jieyi Decoction”, with the course of 14 days. The Ranson scores at 48 hours after admission, and changes of white blood count (WBC), blood urea nitrogen (BUN), fasting blood glucose (FBG), Ca,2+, C reactive protein (CRP) at 24h and 72h were observed. The clinical complications during the course of treatment were compared  Results:① Between before treatment and 48h after treatment in each group, there was statistic significance in Ranson scores in the treatment group (P,<,0.05); after treatment, there was significant difference in Ranson scores between the two groups (P,<,0.05). ② In each group between before and 72h after treatment, there were significant differences in the levels of WBC, BUN, FBG, Ca,2+, and CRP in the treatment group (P,<,0.05), and with significant differences in the levels of WBC, BUN and CRP in the control group (P,<,0.05). Between 24h and 72h after treatment in each group, there were significant differences in the levels of WBC, BUN, FBG and CRP of the treatment group (P,<,0.05), and there were significant differences in the levels of WBC, BUN and CRP of the control group (P,<,0.05). There were significant differences in the levels of FBG, Ca,2+, and CR at 72h after treatment between the two groups (P,<,0.05). ③ During the treatment course, there were significant differences in the incidence of the pancreatic abscess as for the local complication and the pleural effussion and the ARDS as for the systemic complication between the two groups (P,<,0.05). There were significant differences in the mixed complications between the two groups (P,<,0.05)  Conclusion:Combined “Qingxia Jieyi Decoction” and western medicine is effective to control the inflammatory response, relieve pancreas lesion and reduce complication for the treatment of severe acute pancreatitis.