Objective To explore the clinical curative effect and the possible mechanism of Chaishao Chengqi Decoction enema adjuvant treatment of severe acute pancreatitis（ SAP） combined with abdominal compartment syndrome（ ACS）. Methods Eighteen cases of SAP complicated with ACS were randomly divided into control group with 8 cases and treatment group with 10 cases. The control group was treated with conventional western medicine treatment

and in addition to conventional western medicine treatment

the treatment group was added with Chaishao Chengqi Decoction enema

30 minutes each time

twice a day. Both groups were treated for 7 days. Patients’ recovery time of bowel sound

defecation recovery time

and ICU hospitalization days in the two groups were compared. Before treatment and on the 1st

4th

and 7th day of treatment

patients’ intra-abdominal pressure

heart rate

cardiac output and mean arterial pressure

blood gas analysis indices（ p H

oxygenation index

lactic acid

and central venous oxygen saturation）

peak airway pressure and serum bilirubin

alanine aminotransferase transferase（ ALT）

and the serum level of tumor necrosis factor alpha（ TNF-α） were detected. Results The bowel sound recovery time in the treatment group was（ 1. 88 ± 0. 64） days

defecation recovery time was（ 1. 50 ± 0. 53） days

ICU hospitalization days was（ 14. 63 ± 2. 13） days

which were all significantly lower than those（（ 2. 50 ± 0. 53） days

（ 2. 63 ± 0. 74）days

and（ 19. 50 ± 3. 67） days

respectively） in the control group（ P < 0. 05）. The intra-abdominal pressures in the treatment group on the 1st

4th

and 7th day were significantly lower than that before treatment

and the intraabdominal pressures in the control group on the 4th and 7th day after treatment were also lower than that before treatment（ P < 0. 05 or P < 0. 01）. And intra-abdominal pressure on the 1st

4th

and 7th day during the treatment in the treatment group were better than those in the control group（ P < 0. 05）. Various degrees of improvement in the cardiac function indexes were found in both groups after treatment. In the treatment group

the heart rate

cardiac output and mean arterial blood pressure on the 4th and 7th day of the treatment

and the peak pressure improvement on the1 st

4th

and 7th day of the treatment were significantly better than those in the control group（ P < 0. 05 or P <0. 01）. On the 1st

4th

and 7th day of the treatment

the indices of blood gas analysis in the treatment group were significantly improved than before treatment（ P < 0. 5 or P < 0. 1）. In the treatment group

PH value

oxygenation index

and lactic acid on the 1st

4th

and 7th day of the treatment

and the central venous oxygen saturation on the4 th and 7th day of the treatment were significantly improved than those in the control group（ P < 0. 5 or P < 0. 1）. In the treatment group

the serum levels of bilirubin and ALT on the 4th and 7th day of the treatment and TNF-αon the1 st

4th

and 7th day of the treatment were significantly lower than before treatment（ P < 0. 05 or P < 0. 01）

and they were also significantly lower than those in the control group on the same timepoint of the treatment（ P < 0. 05）.Conclusion Chaishao Chengqi Decoction enema adjuvant treatment of SAP combined with ACS can promote the recovery of gastrointestinal function

effectively reduce the pressure in the abdominal cavity

improve cardiac function

and correct acidosis and arterial blood gas condition. The mechanism may be related with the clearance of serum inflammatory cytokines.