Abstract： Objective To investigate the effects of duloxetine combined with pancreatic kininogenase on nerve conduction func-tion and oxidative stress in patients with painful diabetic peripheral neuropathy(PDPN).Methods A total of one hundred and four patients with PDPN treated in our hospital from June 2021 to June 2023 were retrospectively selected and divided into single group(n=52)and combined group(n=52).The single group was treated with pancreatic kininogenase,and the combination group was treated with duloxetine combined with pancreatic kininogenase.Compare the clinical efficacy of the two groups,as well as clinical symptom score,glucose and lipid metabolism,nerve conduction function[sensory nerve conduction velocity(SCV),motor nerve conduction ve-locity(MCV)],nerve factors[Neurogenic growth factor(NGF),insulin like growth factor(IGF-1),brain derived neurotrophic factor(BDNF)]and oxidative stress[Malondialdehyde(MDA),catalase(CAT),superoxide dismutase(SOD)]levels before and after treatment.Results The total effective rate of combination group was 86.54%,which was higher than that of single group 69.23%(P<0.05).After treatment,the clinical symptom score of the combined group was lower than that of the single group(P<0.05).After treat-ment,the fasting blood glucose(FPG),postprandial 2-hour blood glucose(2hPG),total cholesterol(TC),triacylglycerol(TG),and low density lipoprotein cholesterol(LDL-C)levels in the combined group were lower than those in the single group,and SCV and MCV in common peroneal nerve and median nerve were higher than those in single group(P<0.05).After treatment,the serum levels of NGF,IGF-1 and BDNF in combination group were higher than those in single group(P<0.05).After treatment,the serum MDA level of the combined group was lower than that of the single group,and the CAT and SOD levels were higher than that of the single group(P<0.05).Conclusion Duloxetine combined with pancreatic kininogenase is effective in the treatment of PDPN,which can improve clin-ical symptoms,glucose and lipid metabolism,nerve conduction function,promote the recovery of peripheral nerve function,and enhance the antioxidant capacity of the body.