Abstract: Objective To observe the therapeutic efficacy of sodium bicarbonate combined with Xuebijing injection on severe acute dichlorvos pesticide poisoning. Methods A total of 105 eligible patients with severe acute dichlorvos pesticide poisoning were randomly divided into the conventional treatment group(n=52) and the experimental observation group(n=53). The conventional treatment group were given thorough gastric lavage with water, and the experimental observation group were given gastric lavage with 2.5% sodium bicarbonate solution. Both groups were given such treatments as catharsis, administration of oxygen, fluid infusion, diuresis, and antidotes such as atropine and pralidoxime methylchloride. Furthermore, the patients in experimental observation group were treated with both 5% sodium bicarbonate injection and Xuebijing injection. Results The serum cholinesterase activity of patients in the experimental observation group was significantly higher than the conventional treatment group 3 days after treatment,and the difference was statistically significant (P<0.05).The time of atropinization,total atropine dosage,total pralidoxime methylchloride dosage,ICU stay time and the cases of mechanical ventilation(>72 h),serum hsCRP and APACHEⅡ score of the patients in the experimental observation group were significantly lower than in the conventional treatment group, and the differences were statistically significant (P<0.05). The arterial blood pH and HCO₃^- between the two groups had no significant difference(P>0.05). Conclusion Sodium bicarbonate combined with Xuebijing injection could improve the therapeutic effects,reduce complications and shorten EICU stay times in the treatment of severe acute dichlorvos pesticide poisoning,and contribute to the recovery of cholinesterase activity.