Objective To observe the effect of acupuncture intervention on gastrointestinal dysfunction and prognosis of severe patients treated with analgesia and sedation. Methods 83 patients with severe gastrointestinal dysfunction admitted in ICU of our hospital from October 2019 to October 2022 were selected as subjects, and were randomly divided into two groups by envelope method. Both groups of patients were given sufentanil citrate analgesia, 40 patients in the control group were given routine treatment, and 43 patients in the acupuncture group were treated with acupuncture on the basis of routine treatment. To compare the differences between the two groups in disease score, sequential exhaustion of function (SOFA) score, diamine oxidase (DAO), gastrointestinal hormone, urinary lactulose/mannitol (L/M) value, gastric emptying, and the number of bowel sounds, and record the hospitalization time of the two groups. Results There was no significant difference between the two groups in disease score, intra-abdominal pressure and SOFA score before treatment (P＞0.05). After treatment, the scores of acute physiology and chronic health condition (APACHE Ⅱ), intra-abdominal pressure and SOFA in the two groups were lower than before, and the scores in the acupuncture group were lower (P＜0.05). There was no significant difference in gastrointestinal hormone, DAO and urine L/M between the two groups before treatment (P＞0.05). Motilin (MOT) was higher in the two groups after treatment than before, and higher in the acupuncture group (P＜0.05). After treatment, the gastrin (GAS), DAO and urine L/M values in the two groups were lower than before, and the acupuncture group was lower (P＜0.05). There was no significant difference in gastric emptying and the number of bowel sounds between the two groups before treatment (P＞0.05). After treatment, the number of bowel sounds in the two groups was higher than before, and that in the acupuncture group was higher (P＜0.05). After treatment, the gastric emptying time and 24h gastric residue in the two groups decreased, and the acupuncture group was lower (P＜0.05). The hospitalization time in the acupuncture group (18.85±4.66) days was shorter than that in the control group (23.69±5.14) days, with a statistical difference (P＜0.05).Conclusion Acupuncture intervention can regulate gastrointestinal hormones in severe patients with gastrointestinal dysfunction after receiving analgesia and sedation, promote intestinal peristalsis, reduce intra-abdominal pressure, and improve prognosis