Objective To investigate the effect of different prescription for activating blood circulation and resolving blood stasis rats with severe traumatic brain injury（ s TBI） in acute stages. Methods A total of 306 SD male rats were randomly divided into normal group

model group

brain protein hydrolysate group

Taohong Siwu Decoction（ 桃红四物汤） group

Xuefu Zhuyu Decoction（ 血府逐瘀汤） group

Tongqiao Huoxue Decoction（ 通窍活血汤） group and Buyang Huanwu Decoction（ 补阳还五汤） group. The s TBI rat model was prepared by the modified Feeney’ free fall method except the normal group. After successful modeling

the brain protein hydrolysate group

the Taohong Siwu Decoction group

the Xuefu Zhuyu Decoction group

the Tongqiao Huoxue Decoction group and the Buyang Huanwu Decoction group were intragastrically given the corresponding drugs 1. 11 mg/200 g

2. 04 g/200 g

3. 12 g/200 g

1. 92 g/200 g

5. 74 g/200 g respectively. The normal group and the model group were given normal saline 3 ml/200 g

and each group was intragastrically administered once a day for 7 days. The mortality of rats was counted at any time after intragastric administration. The pathological scores of brain tissue were observed on the 1 st

3 rd and 7 th day

and the contents of serum microtubule-associated protein Tau and glial fibrillary acidic protein（ GFAP） were detected. Results During the experiment

there was no death in the normal group and the brain protein hydrolysate group. The deaths of the other groups were mainly during the first 4 days. Compared with the normal group

the death rate of the model group

the Taohong Siwu Decoction group and the Xuefu Zhuyu Decoction was significantly increased（ P < 0. 01）. Compared with the model group

the death rate of the Taohong Siwu Decoction group and the Xuefu Zhuyu Decoction group were also significantly increased（ P < 0. 01）. There was no significant difference between the Tongqiao Huoxue Decoction group and the Buyang Huanwu Decoction group（ P > 0. 05）. Compared with the normal group

the brain histopathological scores and serum Tau and GFAP levels in the rats in all treated groups were significantly increased at 3 time points（ P < 0. 05）. Compared with the model group at the same time point

the pathological scores of the rats in the Xuefu Zhuyu Decoction group

the Tongqiao Huoxue Decoction group and the Buyang Huanwu Decoction group increased on the first day

and the serum GFAP protein level of the Taohong Siwu Decoction group

the Xuefu Zhuyu Decoction group and the Buyang Huanwu Decoction group was increased（ P < 0. 05）. On the3 rd day

in all groups except the Taohong Siwu Decoction group

the pathological scores were lower than those of the model group; The serum Tau and GFAP levels of the brain protein hydrolysate group

the Tongqiao Huoxue Decoction group and the Buyang Huanwu Decoction group decreased（ P < 0. 05）. On the 7 th day

the pathological scores

serum Tau and GFAP levels of all treated groups decreased（ P < 0. 05）. Conclusion The use of Taohong Siwu Decoction and Xuefu Zhuyu Decoction in the acute phase of s TBI could aggravate the condition and increase the risk of death. The best time to treat the acute phase of s TBI with activating blood circulation and resolving blood stasis drugs may be after the 4 th day of injury

and the effect of Tongqiao Huoxue Decoction and Buyang Huanwu Decoction is the best.