Objective To analyze the effect of early high-dose ulinastatin combined with glutamine treatment on the clinical efficacy, inflammatory factors and respiratory function of patients with severe burns. Methods The clinical data of 85 patients with severe burns admitted in our hospital from July 2018 to December 2019 were selected. According to the inclusion and exclusion criteria, 83 patients were selected as the research objects. According to the difference in treatment methods, they were divided into study group (n=43, high-dose ulinastatin combined with glutamine treatment) and control group (n=40, conventional dose of ulinastatin combined with glutamine treatment). The inflammatory factors ［Tumor necrosis factorα（TNF-α), interleukin-6 ( IL-6) and interleukin-8 (IL-8)］, respiratory function ［respiratory frequency,arterial oxygen partial pressure (PaO2), oxygenation index (PaO2/FiO2)］ and immune function ［immunoglobin A (IgA), immunoglobin G (IgG), immunoglobulin M (IgM)］ before treatment, 3d and 12d after treatment were compared between the two groups. The occurrence of adverse reactions in the two groups was observed.Results The total effective rate of the study group (9767%) was higher than that of the control group (8250%) (P＜0.05). The levels of IL-6, IL-8 and TNF-α in the study group increased 3 days after treatment, but reached the lowest value 12 days after treatment. At the same time, IL-6, IL-8 and TNF-α in the study group were lower than those in the control group at any time point after treatment (P＜0.05). Before treatment, there was no difference in the indicators of respiratory function between the two groups (P＞0.05). 3 days after treatment, the respiratory rate of the study group was lower than those before treatment, PaO2 and PaO2/FiO2 were both higher than those before treatment, and reached the lowest value (peak) 12 days after treatment. At the same time, the respiratory rate of the study group was lower than that of the control group at any time after treatment, and both PaO2 and PaO2/FiO2 were higher than those of the control group (P＜0.05). There was no difference in the levels of IgA, IgG and IgM between the two groups before treatment. 3 days after treatment, the levels of IgA, IgG and IgM in each group were significantly lower than before treatment, and increased to a peak on the 12th day. At the same time, the levels of IgA, IgG and IgM in the study group were higher than those in the control group at each time point after treatment (P＜0.05). There was no difference in the incidence of complications between the combined group (6.98%) and the control group (2.50%) (P＞0.05). Conclusion Early high-dose ulinastatin combined with glutamine treatment can improve the inflammatory response and respiratory function in patients with severe burns, and improve their immune function. It has good efficacy and high safety, and is worthy of clinical promotion.