Objective To observe the effects of traditional Chinese medicine compound Jianerji on the apoptosis of outer hair cells (OHC) and spiral ganglion neurons (SGN) of senile cochlea in mice by transmission electron microscope; confocal microscope, combined with morphology Multiple immunofluorescence techniques were used to observe the effect of compound ear-jianing agent on the localization and expression of specific nuclear antigen protein (NeuN) and brain-derived neurotrophic factor (BDNF) of cochlear SGN, and to explore its mechanism. Methods Twenty-two 1-month-old C57BL/6J mice were selected and randomly divided into two groups. Among them, 11 mice drank tap water daily until 7 months as the control group for senile cochlear degeneration (referred to as the 7-month-old control group); 11 The mice drank 1.83 g/(kg·d) of compound ear medicine daily until 7 months as the traditional Chinese medicine intervention group (referred to as the 7-month-old Chinese medicine group). The cochlea was taken out of all animals, and paraffin-embedded sections were prepared.Under the transmission electron microscope, the focus was selected to observe the undisintegrated OHC in the base of the cochlea of the 7-month-old control group and the SGN ultrastructural changes in the corresponding parts. The OHC and SGN of the same part of the group were compared. Using laser confocal microscope, combined with morphological multiple immunofluorescence technology, observe the localization and expression of NeuN and BDNF in SGN, and perform statistical analysis. Results In the 7-month-old control group, there were undisintegrated OHC at the base of the cochlea and SGN in the corresponding part. The cell body was atrophy, the nucleus was irregular, the nuclear chromatin was clustered and edged, the texture structure was blurred, and the electron density was high, especially the size and shape of SGN. Different, the number is significantly reduced, and even nuclear chromatin is dissolved, vacuoles are formed, or disintegration is absent, etc., presenting a serious apoptosis situation. In the 7-month-old Chinese medicine group, the apoptotic status of OHC or SGN in the basal gyrus of the cochlea is not obvious, the cell morphology and structure are relatively complete, the number is large, the nuclear chromatin distribution is relatively uniform, the texture structure is clear, the electron density is low, and only a few nuclei are dissolved and formed Vacuole. Compared with the 7-month-old control group, the localized expression density of NeuN and BDNF in the SGN of the basal gyrus of the cochlea in the 7-month-old Chinese medicine group was higher and the number was higher (P<0.05). Conclusion Cochlear OHC or SGN cell nucleus ultrastructural changes and decreased NeuN expression are important features of cochlear nerve cell apoptosis in senile cochlea; SGN apoptosis is earlier than OHC in the same period; Chinese medicine compound Jianerji can significantly resist the ultrastructural changes of OHC or SGN. Its expression of NeuN in SGN increased significantly, suggesting that traditional Chinese medicine has a significant protective effect on SGN, which is consistent with the observation of transmission electron microscopy. Its mechanism of action is related to promoting the expression of BDNF, thus exerting a series of biological effects.