Objective:To investigate the effect of early treatment with a combination of rhubarb and high volume hemofiltration for patients with severe acute pancreatitis(SAP).Methods: We retrospectively analyzed the 31 SAP patients, who were treated in our department between June 2005 and December 2007.Twelve patients (control group) received high-volume hemofiltration only and the other 19 patients(treatment group)received both hemofiltration and rhubarb-enchyma infused via a gastric tube for three days.The vital signs and recovery of gastrointestinal functions were observed in the two groups.The serum concentrations of tumor necrosis factor-α (TNF-α), interleukin-6 ( IL-6) and plasma endotoxin were measured in the two groups.Results: The vital signs of all the patients were stable during the treatment.The APACHEⅡscore and serum cytokine concentrations were significantly decreased in the two groups after treatment(P＜0.05), and there was no significant difference between the treatment group and the control group (P>0.05).Gastrointestinal function of the treatment group recovered earlier, with an effective rate significantly higher than that of the control group(P＜0.05).The plasma endotoxin of the control group were gradually elevated during the treatment; that of the treatment group increased first and then gradually decreased; and there was significant difference between the two groups(P＜0.05).Conclusion: High-volume hemofiltration can clear the plasma inflammatory mediators and cytokines.Rhubarb can improve the gastrointestinal function and decrease the plasma endotoxin level of SAP patients; early treatment with a combination of both can improve the clinical outcomes of patients.