Abstract： Objective： To observe the clinical efficacy of Buqi Huoxue Tongluo Prescription combined with spreading moxibustion therapy in the treatment of diabetic peripheral neuropathy with qi deficiency and blood stasis syndrome. Methods： A total of 100 patients with diabetic peripheral neuropathy with qi deficiency and blood stasis syndrome treated at Yongkang Hospital of Traditional Chinese Medicine from May 2022 to December 2024 were selected and divided into the control group and the trial group using the random number table method， with 50 cases in each group. During the study，one case dropped out in the control group（49 cases finally included），and two cases dropped out in the trial group（48 cases finally included）. The control group was treated with oral administration of Mecobalamin Tablets，and the trial group received additional oral administration of Buqi Huoxue Tongluo Prescription combined with spreading moxibustion therapy on the basis of the control group. Both groups were treated continuously for eight weeks. The clinical efficacy，Michigan Diabetic Neuropathy Score（MDNS），Toronto Clinical Scoring System（TCSS），nerve conduction velocity of the median nerve and common peroneal nerve， ankle-brachial indexes， and levels of antiglutathione S-transferase IgM antibody（anti-GST-IgM），Visfatin，von Willebrand factor（vWF），lipoxin A4（LXA4）， endothelial cell-specific molecule-1（ESM-1），advanced glycation end products（AGEs），and glycated hemoglobin （HbA1c）were compared between the two groups. Results：After treatment，the total effective rate in the trial group was 95.83%（46/48），which was superior to 79.59%（39/49）in the control group（P＜0.05）. The MDNS and TCSS scores of both groups decreased compared with those before treatment（P＜0.05），and the MDNS and TCSS scores in the trial group were lower than those in the control group（P＜0.05）. The sensory conduction velocity（SCV）and motor conduction velocity（MCV）of the median nerve and common peroneal nerve in both groups were improved compared with those before treatment（P＜0.05）， and the above values in the trial group were higher than those in the control group（P＜0.05）. The ankle-brachial indexes of both groups increased compared with those before treatment（P＜ 0.05），and the ankle-brachial index in the trial group was higher than that in the control group（P＜0.05）. The levels of anti-GST-IgM，AGEs，and HbA1c in both groups decreased compared with those before treatment（P＜0.05），and the levels of these three indicators in the trial group were lower than those in the control group（P＜0.05）. The LXA4 levels in both groups increased compared with those before treatment（P＜0.05），and the LXA4 level in the trial group was higher than that in the control group（P＜0.05）. The levels of Visfatin， vWF， and ESM-1 in both groups decreased compared with those before treatment（P＜0.05），and the levels of these three indicators in the trial group were lower than those in the control group（P＜0.05）. Conclusion：Buqi Huoxue Tongluo Prescription combined with spreading moxibustion therapy for diabetic peripheral neuropathy with qi deficiency and blood stasis syndrome can regulate blood glucose levels， reduce oxidative stress， improve nerve conduction and microvascular endothelial cell function，and alleviate the disease condition.