Objective To observe the effect of pancreatic kininogenase tablets assisted with ulinastatin on microcirculation disorder in patients with acute pancreatitis. Methods 100 cases of patients with acute pancreatitis were randomly divided into the observation group and the control group according to the random number table method, with 50 cases in each group. The patients in the control group were treated with ulinastatin injection of 100, 000 units plus 5% glucose injection and the patients in the observation group were given pancreatic kininogenase on the basis of treatment in the control group, and the course of treatment was 2 weeks. The clinical efficacy of the two groups, the levels of TNF-α, PFA, IL-6, IL-10, whole blood high shear viscosity, whole blood low shear viscosity, plasma viscosity, erythrocyte sedimentation and other hemorheological indexes, thrombin time (TT), prothrombin time (PT), partial activated thrombin time (APTT), D-dimer and other coagulation function and the occurrence of adverse reactions were observed and compared between the two groups before and after treatment. Results The total effective rate of the observation group (94%) was significantly higher than that of the control group (76%). The expression levels of TNF-α, PFA, IL-6 and IL-10 in the two groups were significantly lower than those before treatment, and the expression levels of TNF-α, PAF, IL-6 and IL-10 in the observation group were significantly lower than those in the control group. After treatment, the whole blood high shear viscosity, whole blood low shear viscosity, plasma viscosity and erythrocyte sedimentation indexes were significantly lower than those before treatment, and the hemorheological indexes of the observation group were significantly lower than those in the control group. The coagulation function indexes of TT, PT, APTT and D-dimer in the two groups were significantly longer than those in the control group, and the coagulation function indexes of the observation group was significantly longer than those of the control group. There was no significant difference in the incidence rate of adverse reactions between the two groups. Conclusion Pancreatic kininogenase tables assisted with ulinastatin can effectively improve the clinical symptoms of patients with acute pancreatitis, can dilate the blood vessels by reducing the levels of inflammatory factors and coagulation function to improve microcirculation disorder without increasing the adverse reactions. Therefore it is worthy of clinical promotion and application.