Objective To observe the efficacy of bifidobacterium triple viable bacteria combined with magnesium isoglycyrrhizinate in the treatment of acute pancreatitis (AP) and the effects on levels of serum procalcitonin (PCT) and C-reactive protein (CRP). Methods 109 patients with AP admitted to the hospital from February 2017 to February 2022 were divided into the combined group (n=55) and the control group (n=54) by simple random number table method and random remainder grouping method. Both groups were given conventional medical conservative treatment, and on this basis, the control group was given magnesium isoglycyrrhizinate while the combined group was treated with bifidobacterium triple viable bacteria + magnesium isoglycyrrhizinate, and both groups were treated for 1 week. The clinical efficacy after 1 week of treatment, and Acute Physiology and Chronic Health Evaluation (APACHE II), serum-related factors ［PCT, CRP, interleukin-6 (IL-6)］, microcirculation indicators ［thromboxane A2 (TXA2), prostacyclin (PGI2), platelet activating factor (PAF)］ and intestinal flora count before treatment and after 1 week of treatment were compared between the two groups. Results Within 1 week of treatment, there were no deaths in both groups. The total clinical effective rate in the combined group was higher than that in the control group (P<0.05). After 1 week of treatment, the APACHE II score, serum-related factors (PCT, CRP, IL-6), microcirculation indicators (TXA2, PAF), enterobacter count and enterococcus count in the two groups were significantly reduced compared with those before treatment, and the above indicators were lower in the combined group than those in the control group (P<0.05). Serum microcirculation indicator PGI2 level and intestinal flora counts (bifidobacterium, lactobacillus) in both groups were significantly enhanced compared with those before treatment, and the indicators in the combined group were higher compared to the control group (P<0.05). Conclusion Bifidobacterium triple viable bacteria combined with magnesium isoglycyrrhizinate has an exact efficacy in the treatment of patients with AP. It can effectively reduce the levels of serum PCT and CRP, improve the intestinal microcirculation status, and regulate the intestinal microecological balance