〔Abstract〕 Objective To investigate the effect of rhubarb decoction enema combined with probiotics on gastrointestinal failure in patients with mechanical ventilation in intensive care unit (ICU). Methods A total of 70 patients with mechanical ventilation in ICU admitted to Luohe Hospital of Traditional Chinese Medicine from September 2016 to January 2019 were selected and divided into a control group and an observation group according to different treatment methods, with 35 cases in each group. The patients in the control group were treated with probiotics, and the patients in the observation group were treated with rhubarb decoction enema on the basis of the control group. The clinical therapeutic effects of the two groups were compared. Results The time taken for the recovery of bowel sounds, disappearance of abdominal pain, normal body temperature, disappearance of abdominal distension and hospitalization time in the observation group were less than those in the control group, and the differences were statistically significant (P < 0.05). The total effective rate of the observation group was 85.71 %, which was higher than 71.42 % of the control group, and the difference was statistically significant (P < 0.05). After treatment, acute physiology and chronic health evaluationⅡ (APACHEⅡ) and gastrointestinal function scores of the two groups were decreased to different degrees, and the APACHEⅡ and gastrointestinal function scores of the observation group were lower than those of the control group, and the differences were statistically significant (P < 0.05). After treatment, the serum concentrations of albumin and hemoglobin of the two groups were increased to different degrees, and the serum concentrations of albumin and hemoglobin of the observation group were higher than those of the control group, and the differences were statistically significant (P < 0.05). The mechanical ventilation time of the observation group was (6.31 ± 2.65) d, which was shorter than that of the control group (3.15 ± 1.24) d, and the difference was statistically significant (P < 0.05). Conclusion Rhubarb decoction enema combined with probiotics in the treatment of ICU patients with mechanical ventilation can better provide nutrition for patients, shorten the duration of mechanical ventilation, increase the immune function, and improve the therapeutic effect.