〔Abstract〕 Objective To research and analyse the therapeutic effect of Ganmai Qixian Magnet decoction combined with eszolam tablets on insomnia patients with heart and spleen deficiency syndrome. Methods A total of 100 insomnia patients with heart and spleen deficiency syndrome were selected from the First Affiliated Hospital of Nanyang Medical College from January 2020 to January 2022. According to the random number table method, the patients were divided into an observation group and a control group, with 50 cases in each group. The observation group was treated with Ganmai Qixian Magnet decoction combined with estazolam tablets, while the control group was treated with estazolam tablets. The clinical medication effect, sleep quality, traditional Chinese medica(TCM) syndrome score and sleep related indexes were compared between the two groups. Results 2 weeks and 4 weeks after treatment, the sleep quality scores of the observation group were lower than those of the control group, the differences were statistically significant (P < 0.05); 2 weeks and 4 weeks after treatment, the TCM syndrome scores of the observation group were lower than those of the control group, the differences were statistically significant (P < 0.05); After treatment, sleep efficiency, N3 sleep and the level of serum 5-HT in the observation group were higher than those in the control group, and sleep latency was shorter than that of the control group, the differences were statistically significant (P < 0.05). Conclusion Ganmai Qixian Magnet decoction combined with estazolam tablets in the treatment of insomnia with syndrome of deficiency of both heart and spleen can improve the therapeutic effect and sleep quality of patients.