Abstract：Objective：To observe the clinical effect of enema of Tongfu Xiere mixture combined with routine therapy for fever in patients with severe pneumonia. Methods： A total of 90 cases of patients with fever and severe pneumonia of phlegm-heat obstructing the lung type were randomly divided into the observation group and the control group，45 cases in each group. Both groups were given mechanical ventilation，electrocardiographic monitoring as well as routine therapy and nursing， namely anti- infection， maintaining the balance of water， electrolyte and acid base， expansion of bronchus， physical cooling， dispelling and resolving phlegm and anti- inflammation. At the same period， the observation group was given enema of Tongfu Xiere mixture. Both groups were treated for five days. The fever subsidence time， the degree of disease evaluated by the scores of Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) and Clinical Pulmonary Infection Score(CPIS)，procalcitonin(PCT)，C-reactive protein(CRP) as well as analysis indexes of arterial blood gas，namely partial pressure of oxygen(PaO2)， partial pressure of carbon dioxide(PaCO2) and oxygen saturation(SaO2) were compared between the two groups. Results：After treatment，the scores of APACHE Ⅱ and CPIS in the two groups were decreased when compared with those before treatment(P＜0.01)，and the two scores in the observation group were lower than those in the control group(P＜0.01). The levels of PCT and CRP in the two groups were decreased when compared with those before treatment(P＜0.01)， and the two levels in the observation group were lower than those in the control group(P＜0.01). The levels of PaO2 and SaO2 in the two groups were increased when compared with those before treatment(P＜0.01)，and the levels of PaCO2 were decreased(P＜0.01). The levels of PaO2 and SaO2 in the observation group were higher than those in the control group(P＜0.05)， and the level of PaCO2 was lower than that in the control group(P＜0.05). Conclusion： Based on routine treatment，the enema of Tongfu Xiere mixture for patients with severe pneumonia can relieve fever symptom as early as possible，reduce inflammation and disease severity，and improve ventilation function of the lung，which is conducive to the control of severe pneumonia.