Objective:To observe the effect of Qingxia Huayu decoction combined with conventional western medicine therapy on gastrointestinal function and prognosis scoring system in patients with moderate and severe acute pancreatitis. MethodsSixty-six patients with moderate and severe acute pancreatitis were randomly divided into treatment group and control group, 33 cases in each group. The control group was treated with conventional western medicine, and the treatment group was treated with Qingxia Huayu decoction besides treatment measures of the control group. After 7 days of treatment, the clinical efficacy and gastrointestinal function recovery of the two groups were observed, and the changes of TCM syndrome score, acute gastrointestinal injury (AGI) score, bedside index for severity in acute pancreatitis (BISAP) score, acute physiological and chronic health evaluation II (APACHE II) score and modified computed tomography severity index (MCTSI) score were compared.  Results:①In the course of the trial, the treatment group and the control group lost 3 cases respectively, and 60 cases finally completed the trail with 30 cases in the treatment group and 30 cases in the control group. ②The total effective rates of the treatment group and the control group were 96.7% and 83.3% respectively, and the clinical efficacy of the treatment group was better than that of the control group (P＜0.05). ③TCM syndrome scores in both groups decreased when compared before and after treatment (P＜0.05). After treatment, the difference in TCM syndrome scores between two groups was statistically significant (P＜0.05). ④With the prolongation of treatment time, AGI scores of the two groups gradually decreased (P＜0.05). The AGI score of the treatment group was lower than that of the control group on the 3rd, 7th and 14th day of treatment (P＜0.05). ⑤The time of enteral nutrition reaching the standard and the elapsed time of abdominal pain, abdominal distension, nausea, vomiting and constipation in the treatment group was shorter than that in the control group (P＜0.05). ⑥The scores of BISAP, APACHE Ⅱ and MCTSI decreased in the two groups after treatment and the differences compared before and after treatment were statistically significant (P＜0.05); After treatment, BISAP score, APACHE Ⅱ score and MCTSI score in the treatment group were lower than those in the control group (P ＜0.05).  Conclusion:Compared with conventional western medicine therapy alone, the combined use of Qingxia Huayu decoction with western medicine therapy is more effective in treating moderate and severe acute pancreatitis, which can better promote the recovery of gastrointestinal function and further improve the clinical symptoms and prognosis of patients.