To explore the effects and mechanism of Bushen Huoxue Tongqiao Decoction on auditory brainstem response(ABR)threshold of guinea pigs with gentamycin ototoxicity.Methods:A total of 50 guinea pigs were randomly divided into a blank group,a model group and high/medium/low-dose(H/M/L-dose)experiment groups,with 10 in each group.The model group and the experimental groups were established gentamycin ototoxicity model by intraperitoneal injection of gentamycin sulfate 100 mg/kg daily,and the blank group received intraperitoneal injection of normal saline 25 mL/kg daily.Meanwhile,the H/M/L-dose experiment groups were respectively given intragastric administration of high/medium/low dose of Bushen Huoxue Tongqiao Decoction(containing raw medicine dose of 2.40,0.50 and 0.10 mg/mL)with 0.8 mL for each one.The model group and the blank group were given intragastric administration of the same amount of normal saline.The continuous intervention lasted for 10 d.After the intervention,the ABR threshold of each guinea pig was detected; and the expression of autophagy related protein and cysteine aspartic proteinase-3(Caspase-3)protein in the cochlear tissues of the guinea pigs were observed by Western blotting(WB)and immunohistochemical staining.Results:After the modeling,when compared with the blank group,the ABR threshold,the expression of LC3 and Beclin1 protein in the cochlear tissue and the expression of Caspase-3 protein in the spiral ganglion cells,hair cells and stria vascularis of the guinea pigs in the model group were increased(P<0.05).After the intervention of Bushen Huoxue Tongqiao Decoction,when compared with the model group,the ABR threshold,the expression of LC3 and Beclin1 protein in the cochlear tissue and the expression of Caspase-3 protein in the spiral ganglion cells,hair cells and stria vascularis in the M and H-dose experiment groups were decreased(P<0.05).And there was no significant difference in the above indexes of the L-dose experiment group(P>0.05).Conclusion:Bushen Huoxue Tongqiao Decoction can play a protective role in the damage of gentamicin ototoxicity,and the mechanism is related to the inhibition of autophagy and apoptosis in cochlear cells.