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Based on a data science perspective, this study systematically elucidated the prescription patterns and core compatibility mechanisms of Carthami Flos-containing formulas in the treatment of diabetic peripheral neuropathy(DPN), aiming to provide scientific evidence for optimizing evidence-based TCM therapeutic strategies. A comprehensive literature search was conducted across CNKI, Wanfang, VIP, and PubMed databases, covering publications from database inception to September 18, 2025. Following rigorous screening, 297 clinical studies were included, all focusing on DPN as the primary condition, employing orally administered Chinese herbal medicines, and reporting effective clinical outcomes, encompassing a total of 12 783 cases. Frequency analysis was performed using R software, combined with association rule mining, network topology analysis, prescription similarity assessment, and cluster analysis, to clarify the structural composition and dosage distribution patterns of Carthami Flos-containing formulas. Data analysis showed that decoctions were the predominant dosage form in the clinical treatment of DPN. The core syndrome patterns were highly concentrated in Qi deficiency with blood stasis and combined Qi-Yin deficiency. Major outcome measures included nerve conduction velocity, blood glucose levels, and hemorheological parameters. Within the high-frequency herbal spectrum, Carthami Flos, Astragali Radix, Angelicae Sinensis Radix, Chuanxiong Rhizoma, and Paeoniae Radix Rubra occupied dominant positions. The core prescription network exhibited a compatibility structure centered on Astragali Radix, Chuanxiong Rhizoma, and Angelicae Sinensis Radix, with the "Astragali Radix-Angelicae Sinensis Radix" combination demonstrating the highest support in association rule analysis. The core network-derived combination of "Carthami Flos-Chuanxiong Rhizoma-Paeoniae Radix Rubra-Pheretima-Angelicae Sinensis Radix-Persicae Semen" closely corresponded to the classical formula Buyang Huanwu Decoction. Dosage analysis further revealed that the most common compatibility ratio of Astragali Radix to Carthami Flos was 3∶1, and that the dosages of Astragali Radix(mean 36 g) and Angelicae Sinensis Radix(mean 12 g) frequently exceeded standard pharmacopeial recommendations, reflecting a therapeutic strategy characterized by high-dose Qi supplementation to promote blood circulation. The findings suggest that, despite the complex and mixed deficiency-excess pathogenesis of DPN, blood stasis persists throughout the disease course. Carthami Flos-containing formulas primarily act through tonifying Qi, activating blood circulation, resolving stasis, and unblocking the collaterals, embodying a modern clinical strategy of simultaneous regulation of Qi and blood. This study not only quantitatively validates the guiding significance of classical TCM theories in modern DPN management and elucidates the dose-effect relationships of core prescriptions, but also provides a reproducible methodological framework for mining prescription patterns in complex diseases, offering substantial academic value for the modernization and internationalization of TCM.