Diabetic peripheral neuropathy (DPN) is one of the end-stage complications of diabetes and one of the most common, complex and serious complications in people with diabetes. Some studies have shown that the incidence of neuropathy is about 66% in patients with type 1 diabetes and about 59% in those with type 2 diabetes. The clinical manifestations of diabetic peripheral neuropathy are diverse, and painful diabetic peripheral neuropathy (PDPN) is a type of neuropathy with pain as the main manifestation, which is a kind of neuropathic pain and one of the most complicated and difficult to treat diabetic peripheral neuropathy in clinical practice. Zhenjie Liu, Department of Endocrinology, Guangdong Provincial Hospital of Traditional Chinese Medicine Definition and prevalence of neuropathic pain In 1994, the International Society for the Study of Pain defined pain as an unpleasant sensation or mental experience associated with substantial or underlying tissue damage. Pain is classified into nociceptive pain and neuropathic pain according to the pathophysiological mechanism. In 1994, the International Society for the Study of Pain defined neuropathic pain (neuralgia) as “pain due to a primary lesion or dysfunction of the nervous system”. There are many types of neuropathic pain (Figure), and painful diabetic peripheral neuropathy (or diabetic peripheral neuralgia) is one of the main types, with an incidence of about 40% to 50%, which increases with the duration of diabetes. A 10-year follow-up controlled study in patients with type 2 diabetes showed that the prevalence of painful diabetic peripheral neuropathy (or diabetic peripheral neuralgia) increased from 7% at baseline to 20% at 10 years. Consequences of neuropathic pain Numerous studies have confirmed that regular pain makes it difficult for more than 60% of patients with neuropathic pain to sleep, and that pain intensity is positively correlated with the degree of sleep disturbance. Chronic sleep disturbances can lead to fatigue in 60% of patients, sleepiness and fatigue in 40% of patients, followed by trance, and in severe cases, frustration and irritability in nearly 30% of patients. Neuropathic pain is often accompanied by a decrease in the patient’s quality of life and impairment of various functions, and patients must deal with all three factors simultaneously: chronic pain, sleep disturbance, and anxiety or depression, in order to recover optimally. Diagnosis and treatment of painful diabetic peripheral neuropathy In view of the high incidence and serious consequences of neuropathic pain, the latest international treatment philosophy currently places great emphasis on early diagnosis and early prevention of neuropathic pain. However, due to the diversity of neuropathic pain manifestations and the uncertainty of patients’ complaints at the time of consultation, it is necessary to develop a standardized treatment procedure suitable for domestic clinical practice. From the current clinical practice of neuropathic pain, the diagnosis of painful diabetic peripheral neuropathy is often in the middle and late stages. In addition, there is no specific drug for neuropathic pain in China, and the treatment field is still blank, and the effect of traditional analgesic drugs in clinical practice is poor. Currently, for the treatment of painful diabetic peripheral neuropathy, several international guidelines recommend the use of antidepressants, anticonvulsants, opioid analgesics and other medications, as well as acupuncture or topical medications. However, studies have shown that only 22%-42% of patients are satisfied with the treatment. Therefore, there is an urgent need to develop and apply new treatments that can provide effective treatment for neuropathic pain to the majority of clinicians and patients in China.