Abstract: Objective To investigate the efficacy of early enteral nutrition (enteral nutrition, EN) combined with acute abdomen Ⅲ in the treatment of severe pancreatitis (severe acute pancreatitis, SAP) and its influence on gastrointestinal tract related indicators. Methods A total of 68 patients with SAP admitted to the emergency department of Hangzhou Traditional Chinese Medicine Hospital from July 2014 to June 2018 were randomly divided into observation group and control group (34 cases each) according to the random number table. The control group was placed in the ICU. Enteral nutrition was given within 24 hours. The observation group was supplemented with the self-made traditional Chinese medicine preparation acute abdomen Ⅲ on the basis of the control group. The two groups of patients were continuously used for 7 days. The clinical efficacy and clinical symptom relief time, ICU stay time, gastrointestinal function, inflammation index and complications of the two groups were compared. Results The clinical effective rate of the observation group was 91.18%, the difference was statistically significant compared with the control group(all P＜0.05), and ICU hospitalization. The time was significantly shorter than that of the control group (all P<0.05). After treatment, serum D-lactic acid, ET, DAO, gastrointestinal function score and urinary lactulose/mannitol levels decreased in different degrees (all P<0.05). The D-lactide, ET, DAO, gastrointestinal function scores and urinary lactulose/mannitol levels were lower in the control group than in the control group (all P<0.05). The AMY, CRP, TNF-α and APACHE-Ⅱ scores in the observation group were significantly lower after treatment. In the control group, IL-10 levels were higher than the control group, the difference was statistically significant (all P<0.05); while the 28d mortality rate and complication rate in the two groups after treatment showed no statistical difference (all P>0.05). Conclusion EN combined with acute abdomen Ⅲ treatment of SAP has significant curative effect, which would alleviate clinical symptoms, protect gastrointestinal function and reduce inflammation.