To observe the clinical effect of Buyang Huanwu Tang combined with mecobalamine in the treatment of senile diabetic peripheral neuropathy(DPN).Methods：A total of 76 elderly patients with DPN were selected and divided into the control group and the observation group according to the random number table method，38 cases in each group.The control group was treated with mecobalamine injection，while the observation group was additionally treated with modified Buyang Huanwu Tang based on the treatment of the control group.Before and after treatment，the changes in the levels of fasting blood glucose(FBG)，2-hour postprandial blood glucose(P2hBG)，hemoglobin A1c(HbA1c)，serum ferritin(SF)，superoxide dismutase(SOD)and reduced glutathione(GSH)，and the total symptom scores of neuropathy(TSS)were observed in the two groups；the clinical effect and adverse reactions of the two groups were compared.Results：Compared with those before treatment，the levels of FBG，P2hBG，HbAlc，SF and TSS scores were all decreased(P ＜ 0.05)，while the levels of SOD and GSH were all increased(P ＜ 0.05).After treatment，the levels of FBG，P2hBG，HbAlc，SF and TSS scores in the observation group were lower than those in the control group(P ＜ 0.05)，and the levels of SOD and GSH were higher than those in the control group(P＜0.05).The total effective rate was 89.47%in the observation group，higher than that of 68.42%in the control group(P＜0.05).The total incidence of adverse reactions was 21.05%in the observation group and 15.79% in the control group，there being no statistically significant difference between the two groups(P＞0.05).Conclusion：The therapy of modified Buyang Huanwu Tang combined with mecobalamine in treatment of senile DPN，can reduce levels of blood glucose and SF，and improve oxidative stress response with high drug safety.