Abstract:Objective To investigate the effect of epalrestat on serum level of homocysteine (Hcy) and score of Toronto clinical scoring system (TCSS) in patients with diabetic peripheral neuropathy (DPN). Methods A total of 97 patients with type 2 diabetes mellitus admitted in our Department of Endocrinology and Metabolism from April 2016 to April 2017 were enrolled prospectively, and then randomly divided into epalrestat group (n=33), epalrestat combined with mecobalamin group (n=30) and mecobalamin group (n=34). Mecobalamin tablet (0.5mg/time) and epalrestat tablet (50 mg/time) were given to the corresponding patients orally, 3 times per day, for 3 months. The levels of fasting blood glucose (FBG), 2h postprandial blood glucose (2hPBG), glycosylated hemoglobin A1c (HbA1c) and Hcy, and TCSS score were compared before and after treatment in the 3 groups. SPSS statistics 21.0 was used for data analysis. Analysis of variance or Chi-square test was employed for intergroup comparison based on different data types among the 3 groups, and LSD test was applied for comparison between groups. Results The levels of FBG, 2hPBG and HbA1c were decreased in all the 3 groups after treatment, but without significant differences (P>0.05). There was no statistical difference in the Hcy level and TCSS score in the 3 groups before treatment (P>0.05), but the Hcy level [(11.39±1.39) vs (13.40±2.26)μmol/L, (11.27±2.46) vs (13.51±2.32)μmol/L, (10.13±1.84) vs (14.91±6.78)μmol/L] was decreased in all of them after treatment. The score of TCSS [(7.64±1.87) vs (8.30±2.59); (5.83±1.88) vs (9.13±2.91)] was decreased in the epalrestat and epalrestat combined with mecobalamin group after treatment when compared with before treatment. The treatment of epalrestat combined with mecobalamin resulted in the lowest Hcy level [(10.13±1.84) vs (11.39±1.39) or (11.27±2.46)μmol/L] and TCSS score [(5.83±1.88) vs (7.64±1.87) or (8.59±2.22)] when compared with the treatment of epalrestat or mecobalamin (P<0.05). Conclusion Epalrestat combined with mecobalamin shows obvious effect on DPN patients, and it is worthy of promotion in clinical practice.