目的：通过比较分析痛性糖尿病周围神经病（painful diabetic peripheral neuropathy，DPNPAIN）患者与 非痛性糖尿病周围神经病（diabetic peripheral neuropathy，DPN）患者、不伴周围神经病的糖尿病患者（diabetes patients without peripheral nerve injury，NDPN）患者的临床和肠道菌群特点，探索DPNPAIN预防和治疗 的新靶点。方法：按入排标准筛选 2021年1月至2022年12月在北京友谊医院神经内科或内分泌科就诊的 糖尿病患者，通过病史询问，体格检查及电生理检查，分为3组：DPNPAIN组、DPN组和NDPN组。分析入 组患者的临床基本资料并对粪便标本进行菌群分析。结果：本研究共入组患者112例，分别纳入NDPN组 37例、DPN组41例、DPNPAIN组34例。临床资料分析发现年龄、嗜碱性粒细胞计数、血小板计数、高密度 脂蛋白及糖化血红蛋白可能与DPNPAIN的发生相关。肠道菌群分析发现DPNPAIN组患者粪便中c_Negativicutes 及其分支菌群为优势物种，可能是本病的生物学标志物。结论：本研究通过分组对比观察 DPNPAIN的临床和肠道菌群特点，推测改善肠道菌群，减少c_Negativicutes及其分支菌种的含量，有可能 成为治疗本病的新靶点。

To explore new targets for the prevention and treatment of painful diabetic peripheral neuropathy (DPNPAIN) by comparing and analyzing the clinical and gut microbiota characteristics of patients with DPNPAIN, non-painful diabetic peripheral neuropathy (DPN), and diabetes patients without peripheral nerve injury (NDPN). Methods: Diabetes patients who visited the Department of Neurology or Endocrinology at Beijing Friendship Hospital from January 2021 to December 2022 were screened according to the inclusion and exclusion criteria. They were divided into three groups through medical history inquiry, physical examination, and electrophysiological examination: DPNPAIN group, DPN group, and NDPN group. The basic clinical data of the enrolled patients were analyzed, and stool samples were collected for microbial analysis. Results: A total of 112 patients were enrolled in this study, with 37 cases in the NDPN group, 41 cases in the DPN group, and 34 cases in the DPNPAIN group. Clinical data analysis found that age, eosinophil count, platelet count, high-density lipoprotein, and glycosylated hemoglobin may be related to the occurrence of DPNPAIN. Gut microbiota analysis found that c_Negativicutes and its branching populations were dominant species in the feces of DPNPAIN group patients, which may be biological markers of this disease. Conclusion: This study observed the clinical and gut microbiota characteristics of DPNPAIN through group comparison, speculating that improving the gut microbiota and reducing the content of c_Negativicutes and its branching species could become a new target for the treatment of this disease.