Xing-Qi-Tong-Qiao Decoction (XQTQ) is a traditional Chinese prescription that embodies the homology of medicine and food. It is recognized for its effects in alleviating stasis, dispersing phlegm and nodules, activating blood circulation, relieving pain. However, its efficacy and mechanisms in alleviating paclitaxel-induced peripheral neuropathic pain (PIPNP) remain unclear. In this study, we investigate the analgesic effects of XQTQ and explore the potential mechanism using plasma metabolomics. The characteristic chromatogram of XQTQ was established using HPLC. A total of 36 SD rats were divided into 6 groups: control, model, positive drug, and three XQTQ combined groups. All rats, except those in control group, were induced with diseases features via intraperitoneal administration of paclitaxel. The pregabalin and XQTQ combined groups were administered orally once a day for 14 days. The paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were measured. Rat plasma was collected for the detection of pain cytokines and the analysis of endogenous metabolite. Rats in the XQTQ combined groups exhibited a significant increase in PWT and PWL values, alongside a decrease in the levels of tumor necrosis factor-alpha (TNF-α, 14.82%), interleukin-6 (IL-6, 13.69%), interleukin-1 beta (IL-1β, 19.34%), nerve growth factor (NGF, 11.40%), prostaglandin E2 (PGE 2, 12.74%), and 5-hydroxytryptamine (5-HT, 13.51%) compared to the model group (P < 0.01). Plasma metabolomics revealed 12 potential biomarkers associated with the model rats, which were significantly reversed by XQTQ. The main pathways involved included glycerophospholipid metabolism, linoleic acid (LA) metabolism, and alpha-linolenic acid (ALA) metabolism. XQTQ demonstrated significant analgesic effects and improved metabolism in the context of PIPNP. This research provides a reliable theoretical basis and novel research directions for clinical applications.