Abstract： Objective： To observe the clinical effect of therapy of retention enema with Jiedu Tongyi Decoction combined with routine therapy on hyperlipidemic severe acute pancreatitis. Methods：A total of 88 patients with hyperlipidemic severe acute pancreatitis with syndrome of intermingled blood stasis and toxin were selected and randomly divided into the control group and the observation group. The two groups were given routine therapy，and the observation group was additionally treated with retention enema with Jiedu Tongyi Decoction. The two groups were treated for ten days. Before and after treatment，the scores of Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ) and Sequential Organ Failure Assessment (SOFA) in both groups were evaluated； the serum amylase (AMS) and the indexes of intestinal mucosal barrier function， including endotoxin， D- lactic acid and diamine oxidase (DAO)， and of inflammatory factors，including intercellular cell adhesion molecule- 1 (ICAM- 1)，interleukin- 6 (IL- 6) and procalcitonin (PCT) were detected； the clinical effects were compared between the two groups； the changes of symptoms and signs of patients and the incidence of adverse reactions were observed. Results： After treatment，the total effective rate was 92.86% in the observation group and 76.19% in the control group， the difference being significant (P＜0.05). The duration of abdominal distention and abdominal pain in the observation group were shortened when compared with those in the control group，and the first exhaust time and first defecation time were earlier than those in the control group，differences being significant (P＜ 0.05). The APACHEⅡscores，SOFA scores and levels of endotoxin，D- lactic acid，DAO，AMS，SAA， ICAM- 1，PCT and IL- 6 in the two groups were decreased when compared with those before treatment (P＜0.05)；the above two scores and seven levels in the observation group were lower than those in the control group (P＜0.05). There were no significant adverse reactions in the two groups during treatment. Conclusion： The therapy of retention enema with Jiedu Tongyi Decoction combined with routine therapy has a good clinical effect on hyperlipidemic severe acute pancreatitis， which can effectively improve the clinical symptoms and signs of patients， maintain the intestinal mucosal barrier function， and inhibit the inflammatory responses with good safety.