Background Chemotherapy-induced peripheral neuropathy (CIPN) not only affects the tolerability of chemotherapy, but also causes intolerable and prolonged neuropathic pain in cancer patients. Currently, duloxetine is the only drug used to treat CIPN. However, the clinical use of this drug still faces several challenges. Therefore, we focused on traditional Chinese medicine (TCM) to find an effective and safe alternative medicine. Huangqi Guizhi Wuwu Decoction (HGWD) is a traditional Chinese medicine that has been clinically used for treating nerve pain for thousands of years. This study aimed to investigate the neuroprotective effect of HGWD on cisplatin-induced nerve injury in PC12 cells and to elucidate its potential mechanism of action. Methods HGWD-containing serum and blank serum were prepared from a rat model. The protective effects of HGWD on cisplatin (10 µmol/L)-induced PC12 cell injury were assessed by a Cell Counting Kit-8 (CCK-8) assay. RNA expression in HGWD-protected PC12 cells was analyzed using RNA-seq, and subsequently, differentially expressed genes (DEGs) were further analyzed using Gene Ontology (GO) and Gene Set Enrichment Analysis (GSEA). Results The CCK-8 results showed that pretreatment of PC12 cells with HGWD-containing serum (5%, 10%, 15%) significantly increased cells' viability to 10 µmol/L cisplatin-induced cell death. RNA-seq analysis revealed 843 DEGs in the CIPN group and 249 in the HGWD group. The GSEA results in this study suggest that HGWD may treat CIPN by enhancing axon guidance. Conclusions This study provides valuable evidence for using HGWD in treating CIPN, partially achieved by improving axon guidance pathways.
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