Abstract：Objective：To observe the clinical effect of the therapy of enema with Rhei Radix et Rhizoma and external application of Natrii Sulfas combined with Pantoprazole on severe acute pancreatitis (SAP) and its influence on serum amylase (AMY) and lipase (LPS). Methods：A total of 86 SAP patients were selected as study objects and randomly divided into the control group and the observation group，with 43 patients in each group. The control group was treated with Pantoprazole based on nutritional support，spasmolysis and pain relief，anti-infection and gastrointestinal decompression，and the observation group was additionally treated with enema with Rhei Radix et Rhizoma and external application of Natrii Sulfas based on the treatment of the control group. The clinical effects， the traditional Chinese medicine (TCM) syndrome scores， gastrointestinal function recovery time， complication rates， and levels of interleukin- 6 (IL- 6)， tumor necrosis factor-α (TNF-α)，AMY and LPS were compared before and after treatment between the two groups. Results： The total effective rate was 90.70% in the observation group and 69.77% in the control group，the difference being significant (P＜0.05). After treatment，the scores of abdominal pain and distension， impediment and fullness， and dryness and excess in the two groups were decreased when compared with those before treatment (P＜0.05)，and the above TCM syndrome scores in the observation group were lower than those in the control group (P＜0.05). After treatment，the serum levels of IL-6 and TNF-α in the two groups were decreased when compared with those before treatment (P＜0.05)，and the levels of IL- 6 and TNF- α in the observation group were lower than those in the control group (P＜0.05). After treatment，the AMY and LPS levels in the two groups were decreased when compared with those before treatment (P＜0.05)，and the AMY and LPS levels in the observation group were lower than those in the control group (P＜0.05). After treatment，the abdominal pain relief time，abdominal tenderness relief time，defecation recovery time and bowel sound recovery time in the observation group were shorter than those in the control group， the difference being significant (P＜0.05). During the treatment period， the incidence of complications was 4.65% in the observation and 16.28% in the control group，there was no significant difference between the two group. Conclusion： The therapy of enema with Rhei Radix et Rhizoma and external application of Natrii Sulfas combined with Pantoprazole can reduce the inflammatory reactions of the body，enhance the TCM syndromes，accelerate the recovery of gastrointestinal function， and effectively improve the clinical effect.