Abstract: Objective: To explore the effects of Qingyi decoction combined with enteral nutrition( EN) in the sequential treatment of severe acute pancreatitis( SAP) . Methods: Forty-one patients with SAP were randomly divided into treatment group( 21 cases) and control group( 20 cases) . The control group were treated with routine method combined with parenteral nutrition， the treatment group were sequentially treated with Qingyi decoction combined with enteral nutrition. The abdominal symptoms and signs， time of intestinal function recovery， incidence of peripancreatic abscess /pseudocyst， fatality rate and hospital stays in two groups were recorded. The acute physiology and chronic health evaluation Ⅱ score，serum albumin concentration and CT scan of upper abdominal were investigated within 24 hours of admission and at 7th day，14th day after treatment. Results: The time of intestinal function recovery and WBCrestore， and hospital stays in treatment group were less than those in the control group( P ＜ 0. 01) . At 7 th and 14th day after treatment，the acute physiology and chronic health evaluation Ⅱ score and CT severity index in treatment group were lower than those in control group( P ＜ 0. 05 － P ＜ 0. 01) ，but its serum albumin concentration was high( P ＜ 0. 01) . Conclusions: The sequential therapy of Qingyi decoction combined with enteral nutrition can significantly promote the disease recovery，short hospital stays and improve patient prognosis，which has better clinical application value.