OBJECTIVE: To investigate the effect of the periplaneta americana extract on the intestinal mucosal barrier and prognostic implications in patients with sepsis. METHODS: Sixty and six patients with sepsis were assigned randomly to treatment group (32 cases) and control group (32 cases). The extractfrom periplaneta americana plus conventional medication for sepsis was administered to the treatment group, while the control group only received conventional treatment. The gastrointestinal function scores and acute physiology and chronic health evaluation II (APACHEⅡ) scores of all subjects were documented at baseline, at days 1, 3 and 7 after treatment respectively and their blood endotoxin was tested at the same time points as well.The incidence of death was recorded for both groups throughout the trial. RESULTS: At days 3 and 7 after treatment, gastroin-testinal function score, APACHE II, and endotoxin level in treatment group wasbetter than that in control group and the difference between them was significant (both P 0.05). CONCLUSION: The extract of periplaneta americana had protective effect on intestinal mucosal barrier and could improve the condition and prognosis in patients with sepsis.