AIM:To investigate the effect of nutritional support therapyon severe acute pancreatitis (SAP).METHODS:A total of 96 patients with severe acute pancreatitiswere divided randomly into control and treatment groups.The former group received total parenteral nutrition (TPN)via central venous infusion,while parenteral nutrition (PN)and enteral nutrition (EN) therapies were applied in differentphases for the latter group.The nutrition status,acute phaseresponses,pancreas lesions,enteric mucosa penetrabilityand immune functions were monitored.RESULTS:Body weight and prealbumin concentration wereincreased in treatment group,compared to those in the controlgroup,but albumin concentration did not change significantly.Acute physiology and chronic health evaluation II (APACHE II)scores decreased after 7 d of treatment,whereas the scores ofthe control group decreased on the 11~(th) day.Concentrations oftumor necrosis factor-α (TNF-α),interleukine-6 (IL-6) andserum C reactive protein (CRP) dropped earlier in thetreatment group (on the 4~(th) day) than that in the control group(on the 7~(th) day).No difference was observed in pancreaticlesions between the control and treatment groups.Concentration of endotoxin and lactulose/manicol (L:M) ratioof urine did not change in treatment group,but those in thecontrol group were elevated markedly.Compared with thetreatment group,CD4:CD8 T cells ratio and immunoglobulin G(IgG) concentration in the control group decreased significantly.CONCLUSION:Compared to TPN,the combined therapyof EN and PN could improve the nutrition status and moderatethe acute phase response obviously.Moreover,the integrityof enteric mucosa and immune function were protected moreeffectively in treatment group than in the control one.Onthe other hand,EN did not simulate the excretion of pancreasand avoid exaggerating the inflammation of pancreas.Thus,appropriate application of PN and EN appears to be moreeffective for patients with SAP. AIM: To investigate the effect of nutritional support therapy on severe acute pancreatitis (SAP). METHODS: A total of 96 patients with severe acute pancreatitiswere divided randomly into control and treatment groups. The former group received total parenteral nutrition (TPN) via central venous infusion , while parenteral nutrition (PN) and enteral nutrition (EN) therapies were applied in differentphases for the latter group. The nutrition status, acute phaseresponses, pancreas lesions, enteric mucosa penetrability and immune functions were monitored .RESULTS: Body weight and prealbumin concentration were reinforced in treatment group, compared to those in the control group, but albumin concentration did not change significantly. Acute physiology and chronic health evaluation II (APACHE II) scores decreased after 7 d of treatment, but the scores of the control group decreased on the 11 ~ (th ) day. Confidence of tumor necrosis factor-α (TNF-α), interleukine-6 ​​(IL-6) and serum C reactive protein (CRP) dropped earlier in the treatment group (on the 4th day) than that in the control group (on the 7th (th) day) .No difference was observed in pancreaticles between the control and treatment groups. Confluence of endotoxin and lactulose / manicol (L: M) ratio of urine did not change in treatment group, but those in the control group were elevated markedly. Compared with the treatment group, CD4: CD8 T cells ratio and immunoglobulin G (IgG) concentration in the control group decreased significantly.CONCLUSION : Compared to TPN, the combined therapy of EN and PN could improve the nutrition status and moderate the acute phase response obviously. Moreover, the integrity of enteric mucosa and immune function were protected more effectively in treatment group than in the control one. Nothe other hand, EN did not simulate the excretion of pancreas and avoid exaggerating the inflammation of pancreas.Thus, appropriate application of PN and EN appears to be more effective for patients with SAP.