Wu, a 70-year-old male, was admitted to the hospital with recurrent dry mouth and excessive drinking for five years and left eye diplopia for one month. The patient was diagnosed as “diabetic” five years ago when he visited a local hospital for dry mouth and was given oral hypoglycemic medication. In late November 08, the patient presented with left eyelid ptosis with diplopia without any obvious cause, and then visited a hospital. On examination, the left pupil was slightly larger than the right, and the left eye was out of place on the right side of the gaze, without nystagmus, with normal sensation and movement. Cranial MRI: multiple ischemic luminal infarcts in the brain parenchyma. Arterial MRA: no abnormalities were found in the cranial arteries. Carotid ultrasound: bilateral carotid plaque formation, mild stenosis of the right carotid artery, thin right vertebral artery. cta: mixed plaque formation at the bifurcation of the right carotid artery with slight narrowing of the official lumen, no significant abnormality in cranial vascular cta. Electromyography: normal. The diagnosis was “incomplete palsy of the left arterial nerve (aneurysm?)”. . The diagnosis: double vision in the left eye, numbness and tingling in both heels, dry mouth and excessive drinking were not obvious, sleepiness and sleepiness were acceptable, and bowel movements were regulated. He had a history of hypertension for ten years, did not take antihypertensive drugs, and his blood pressure was generally measured at 130/80 mmHg. He denied smoking and drinking habits. Examination: BMI: 24.46kg/m2, BP: 135/80mmHg, clear consciousness, pupils equal in size and round, left eye right gaze is not in place, light reflex exists, left eyelid slightly drooping, diplopia, nystagmus (-), skin temperature of lower extremities normal, dorsal foot artery pulsation exists, dorsal vibratory sensation of big toe is diminished on the right and normal on the left, bilateral knee reflex exists, bilateral ankle reflex disappears, bilateral pinprick The sensation of pinprick is present bilaterally, and the 10g filament is normal to touch. The tongue is red, the coating is yellow and greasy, and the pulse is thin. Diagnosis on admission: type 2 diabetes mellitus, diabetic arteriolar nerve damage. Diabetic neuropathy is one of the three major complications of diabetic microvascular disease (retinopathy, nephropathy, neuropathy) with an incidence of over 60%. It mostly involves peripheral nerves. The most common clinical manifestation is distal symmetric sensorimotor neuropathy with symmetric pain and sensory abnormalities, which is more severe in the lower extremities than in the upper extremities. Diabetic nerve damage is a diabetic mononeuropathy, which is less common clinically, but in recent years, its incidence has been on the rise and deserves attention. Diabetes-induced cranial nerve damage is most likely to involve the III, IV, and VI pairs of cranial nerves (i.e., the oculomotor, trochlear, and abducens nerves), with damage to the oculomotor and abducens nerves being particularly common. The typical clinical presentation of articular nerve damage is acute ptosis with diplopia and ipsilateral headache. However, it is important to note that 14-18% of patients with diabetic arteriolar nerve damage may have pupillary abnormalities. The articular nerve damage usually resolves within 2.5 months, but may recur in 25% of patients. In addition to the oculomotor, abducens, and talocrural nerves, the cranial nerves involved in diabetes have been reported to include the facial, olfactory, optic, trigeminal, auditory, and vagus nerves, resulting in clinical manifestations such as unilateral peripheral facial palsy (Bell’s palsy) and trigeminal neuralgia. The pathogenesis of the disease is still unclear, but it is generally believed to be related to diabetic polyneuritis or obstruction of the tiny blood vessels that nourish the nerves, and long-term poor glycemic control can directly affect its occurrence and development. After admission, the patient was given Eugenol 70/30 for blood glucose control, and then added Bexin for poor postprandial glucose control. At the same time, the patient was given Chinese herbal medicine to benefit qi and nourish yin, tonify liver and kidney, clear heat, activate blood circulation and promote dampness, such as: princeton ginseng, astragalus, turtle shell, raw earth, yellow essence, wolfberry, dendrobium, dulcimer, jujube, smallpox powder, cornus, poria, hawthorn, raw rice kernel, kudzu root, cypress, phellodendron, pseudostellaria, pseudostellaria, pseudostellaria. Radix Salviae Miltiorrhiza, Radix Rehmanniae, Rhizoma Polygonatum and Rhizoma Polygonatum. In addition, we gave our own preparation of Ginseng Scorpion Pain Relief Capsules for oral administration to activate blood circulation and eliminate blood stasis, extinguish wind and promote circulation. Since the occurrence of diabetic neuropathy is closely related to hyperglycemia, controlling blood sugar is the fundamental principle of treatment. We know that the danger of hyperglycemia is manifested in two ways: chronic persistent hyperglycemia and fluctuation of blood glucose level. It has been found that the occurrence and development of chronic complications of diabetes are not only closely related to the overall increase in blood glucose levels, but are also closely and positively correlated with blood glucose volatility. The patient had irregular hypoglycemia on weekdays, and to avoid hypoglycemia he added meals on his own. Although the glycosylated hemoglobin was 7% after admission, his 24h ambulatory glucose monitoring suggested that there were significant blood glucose fluctuations. We added α-glucosidase inhibitor and provided reasonable guidance on meal addition to stabilize his blood glucose within a short period of time. We also used western medical treatment such as nerve nutrition, antioxidant, and improvement of microcirculation on this basis. According to the patient’s symptomatology and tongue and pulse, the patient was considered to have “liver and kidney yin deficiency and internal dampness and heat”. In the beginning of the disease, dry heat or damp heat in the lung and stomach is the most common cause of the disease, and after the disease has subsided for a long time, the dry heat will rob the yin liquid, and the disease is caused by the injury of the lung and stomach fluids, resulting in the loss of essence and blood of the liver and kidney. The liver is open to the eyes, the liver and kidney essence and blood deficiency is not above the glorification of the eye system, resulting in diplopia. Insufficient essence and blood of liver and kidney, liver yang turns into wind and goes to the extremities, resulting in numbness of the heel. The disease of thirst is based on yin deficiency, and yin deficiency consumes qi over time, and qi deficiency is weak, with delayed blood flow and stagnant veins. Therefore, while using the medicinal flavors for the liver and kidneys, the appropriate use of blood invigorating and blood stasis removing, wind quenching and clearing the channels can also bring better results for the patient. On the eighth day of admission, the patient’s blood sugar was stable and her diplopia improved. On the tenth day of admission, there was no diplopia when walking on flat ground, but occasional diplopia when walking up and down stairs. The patient’s life returned to normal, and there was no obvious obstacle in going out and reading, so the treatment effect was satisfactory. At the follow-up visit one quarter later, the patient’s condition did not recur and the blood glucose control was stable. Chinese medicine has accumulated rich clinical experience in the long-term practice of prevention and treatment of diabetes and its chronic complications. In recent years, the advantages of TCM treatment for diabetic neuropathy have become more and more prominent. Due to the complex pathogenesis of this disease, the best clinical efficacy can only be obtained by combining Chinese and Western medicine. It is believed that with the continuous improvement of basic research and clinical treatment, Chinese medicine will play a greater role in the prevention and treatment of diabetic neuropathy to serve the majority of diabetic patients.