To investigate the effects of Huangqi Guizhi Wuwu Decoction（黄芪桂枝五物汤）on microRNA-146a（miR-146a），myeloid differentiation factor 88（MyD88）/inhibitor of nuclear factor-κB inhibitory protein（IκB）signaling pathway in diabetic peripheral neuropathy（DPN）patients.

A total of 108 DPN patients were selected and divided into treatment group and control group by random number table method，with 54 cases in each group.The control group was treated with mecobalamine and vitamin B₁，and the treatment group was treated with Huangqi Guizhi Wuwu Decoction.The course of treatment in both groups was 3 months.The clinical efficacy of the two groups was evaluated.Traditional Chinese medicine（TCM）syndrome score，sensory nerve conduction velocity（SNCV），motor nerve conduction velocity（MNCV），Toronto Clinical Scoring System（TCSS）score，the levels of miR-146a，MyD88 protein，IκBαprotein and phosphorylated-IκBα（p-IκBα）protein before and after treatment and the occurrence of adverse reactions were compared between the two groups.

The total effective rate of the treatment group was 92.59%（50/54），which was significantly better than 77.78%（42/54）of the control group（P<0.05）.After treatment，the scores of TCM syndrome in both groups were improved compared with those before treatment（P<0.05），and the treatment group was better than the control group（P<0.05）.After treatment，the total knee SNCV，median SNCV，total knee MNCV，median MNCV and TCSS scores of both groups were improved compared with those before treatment（P<0.05），and the treatment group was better than the control group（P<0.05）.After treatment，the levels of miR-146a，MyD88 protein，IκBαprotein and p-IκBαprotein in the treatment group were improved compared with those before treatment（P<0.05），and the treatment group was better than the control group（P<0.05）.There was no difference in the incidence of adverse reactions between the two groups（P>0.05）.

Huangqi Guizhi Wuwu Decoction has good efficacy in DPN.It can effectively reduce clinical symptoms，improve nerve conduction velocity，inhibit the expressions of miR-146a and MyD88/IκB signaling pathway，and has high safety.