To explore effects of Compound Shexiang Injection combined with ganglioside on neuronal apoptosis and expressions of neurofilament 200(NF200),growth-associated protein 43(GAP-43)and death-associated protein kinase 1(DAPK1)in rats with diffuse axonal injury(DAI).Methods:DAI rat models were established using a rat skull transient rotation injury device.Forty-five DAI rats successfully established were randomly divided into model group,test group and combined group,with 15 rats in each group.Another 15 normal rats were selected as control group.Rats in the test group were intraperitoneally injected with monosialotetrahexosyl ganglioside sodium[30 mg/(kg·d)],rats in the combined group were injected intraperitoneally with monosialotetrahexosyl ganglioside sodium(30 mg·kg-1·d-1)+Compound Shexiang Injection(2 mL·kg-1·d-1),and the model and control groups were injected intraperitoneally with the same amount of normal saline,for 7 d.Modified neurological severity score(mNSS)method was used to evaluate neurological deficits in each group of rats.Hematoxylin-eosin(HE)staining was used to observe pathological changes of brain tissue in rats.TdT-mediated dUTP Notch End Labeling(TUNEL)was used to detect neuronal apoptosis in each group of rats.Protein expressions of NF200,GAP-43 and DAPK1 in rat brain tissue were detected by Western blot(Wb)method.Results:From the 1st to 7th d of the intervention,the mNSS scores of rats in the model group,the combined group and the test group were gradually decreased.Compared with the control group,the mNSS scores of the rats in the model group were significantly increased from the 1st to 7th d,but those in the combined group and the test group were lower than those in the model group,and those in the combined group were lower than those in the test group(P < 0.05).Compared with the control group,the neuronal apoptosis index and the relative expression of DAPK1 protein in brain tissue of rats in the model group were significantly increased,and those in the combined group and the test group were lower than those in the model group,and those in the combined group were lower than those in the test group(P < 0.05).The relative expressions of NF200 and GAP-43 proteins were significantly decreased,and those in the combined group and the test group were higher than those in the model group,and those in the combined group were higher than those in the test group(P < 0.05).Conclusion:Compound Shexiang Injection combined with ganglioside in the treatment of DAI can improve neurological deficits in rats,inhibit neuronal apoptosis,and improve neural function.Its mechanism of action may be related to up-regulation of NF200 and GAP-43 protein expressions in brain tissue and down-regulation of DAPK1 protein expression,and the combined use of the 2 drugs is more effective.