Objective To observe the efficacy of early feeding Tongfuyidan decoction in the treatment of SAP by three-lumen gastrojejunal tube. Methods Patients with severe acute pancreatitis were randomly divided into group A (n=22), group B (n=21) and group C (n=21).Based on routine comprehensive treatment, such as intensive care , anti-infection, somatostatin inhibition of pancreatic secretion, fluid resuscitation, maintenance of water and electrolyte balance .group A was given Tongfuyidan decoction by nasogastric feeding, while group B was given Tongfuyidan decoction by three-lumen gastrojejunal tube feeding, and patients in control group were given lactulose by nasogastric feeding. Patients in each group received measurments at the same point in time of APACHE Ⅱ score, serum amylase, high-sensitivity C-reactive protein , and the tolerance, the recovery time of intestinal function and hospital stay of patiens feeded by medicine or lactulose through different routes. Results On day 7 after admission, both the APACHE Ⅱ score and high-sensitivity C-reactive protein in group A and group B were significantly lower than those in group C(5.30±2.15 vs 6.95±2.25, P<0.05; 5.45±1.80 vs 6.95±2.25, P<0.05). The incidence rate of nausea, vomiting, aggravated abdominal pain in group B was dramatically lower than in group A(14.3% vs 45.5%,P<0.05). Similarly, the recovery time of intestinal function in group B was also notably shorter than in group A(6.67±1.49 vs 8.36±2.54, P<0.05). The hospital stay in two groups given Tongfuyidan decoction were significant shorter than in lactulose treatment group[(15.73±2.68)d vs (19.24±6.42)d, P<0.05;(14.86±2.86)d vs (19.24±6.42)d, P<0.05]. Conclusions Early feeding through three-lumen gastrojejunal tube can significantly improve dosing compliance, reduce incidence of nausea and vomiting, shorten recovery time of intestinal function , shorten hospital stay, so improved the prognosis significantly.