Abstract: Objective To observe the clinical efficacy of Ling Gui Ba Fa combined with TCM fire-needle acupuncture therapy in improving the quality of sleep in patients with insomnia due to heart-spleen deficiency. Methods Seventy-two cases of patients with Heart-spleen deficiency insomnia in our hospital from January, 2016 to January, 2017 were randomly divided into group A (36 cases) and group B (36 cases); there were 1 case of lost follow-up in each group, and 35 cases in each test group were finally completed. Group A received Ling Gui Ba Fa combined with TCM fire-needle acupuncture therapy (Xinyu and Piyu acupoints), while group B received conventional acupuncture therapy (Zhaohai, Sishencong and Sanyinjiao acupoints), one time a day for 5 times a week. Pittsburgh sleep quality index (PSQI), TCM symptom score were evaluated before treatment, 2 weeks, 4 weeks and one month after the treatment. Data were analyzed by SPSS soft. The therapeutic efficacy was compared between the two groups. Results There was no obvious difference in the scores of PSQI and TCM symptoms after 2 weeks of treatment between the two groups (P>0.05); the difference in PSQI score and TCM symptom score between the two groups at the end of the 4 week treatment and during the follow-up was significant (P<0.05). At the end of 4 week treatment, the total effective rate of group A was 94.3% (33/35), which was better than that of B group (29/35, P<0.05). Conclusion The long term effect of Ling Gui Ba Fa combined with TCM fire-needle acupuncture therapy for insomnia due to heart-spleen deficiency is better than ordinary acupuncture, and can improve the symptoms of insomnia and sleep quality of the patients.