To observe the clinical effect of Pingyi Guanchang decoction on severe acute pancreatitis.Methods：According to the random number table，divided 60 cases of patients with severe acute pancreatitis into the control group and the observation group，with 30 cases in each group.Both groups received routine treatment by reference to the guideline，while the observation group was additionally given Pingyi Guanchang decoction for enema.Observed the two groups continuously for 7 days.Compared the extinction time of symptoms and recovery time of signs as well as the recovery time of serum amylase and lipase，white blood cell count(WBC)and C-reactive protein(CRP)in the two groups.Results：The remission time of abdominal distension and abdominal pain and the recovery time of intestinal sound，anus defecation and temperature in the observation group were shorter than those in the control group，difference being significant(P＜0.01).The recovery time of serum amylase and lipase，WBC and CRP in the observation group was shorter than that in the control group，difference being significant(P ＜ 0.01).After treatment，the total effective rate was 90.00%in the observation group，being higher than that of 63.33%in the control group，compared the two groups，difference being significant(P ＜ 0.05).Conclusion：Based on routine treatment，the application of Pingyi Guanchang decoction for severe acute pancreatitis can promote the improvement of symptoms and signs and improve the clinical effect.