Abstract： Objective： To observe the clinical effect of Huanglian Shengdi Decoction combined with Estazolam Tablets on insomnia of yin deficiency and vigorous fire type. Methods： A total of 104 cases of patients with insomnia of yin deficiency and vigorous fire type were divided into the control group and the observation group according to the random number table method，with 52 cases in each group. The control group was treated with Estazolam Tablets， and the observation group was additionally treated with Huanglian Shengdi Decoction based on the treatment of the control group. Both groups were treated for one month. Clinical effects were evaluated in the two groups. Traditional Chinese medicine syndrome scores， sleep quality，awakening degree，and the levels of serum 5-hydroxytryptamine (5-HT) and dopamine (DA) were compared between the two groups before and after treatment. The incidence of adverse reactions was counted. Results： The total effective rate was 96.15% in the observation group， higher than that of 82.69% in the control group (P＜0.05). After treatment，each traditional Chinese medicine syndrome score in the two groups was decreased when compared with that before treatment (P＜0.05)，and each score in the observation group was lower than that in the control group (P＜0.05). After treatment， the scores of Pittsburgh Sleep Quality Index (PSQI) and Hyperarousal Scale (HAS) in the two groups were reduced when compared with those before treatment (P＜0.05)，and the scores of PSQI and HAS in the observation group were lower than those in the control group (P＜0.05). After treatment，5-HT levels in the two groups were increased when compared with those before treatment (P＜0.05)， and DA levels were decreased when compared with those before treatment (P＜0.05)；5-HT level in the observation group was higher than that in the control group， and DA level was lower than that in the control group (P＜0.05). The incidence of adverse reactions was 3.85% in the observation group，lower than that of 15.38% in the control group (P＜ 0.05). Conclusion： Huanglian Shengdi Decoction combined with Estazolam Tablets has a definite curative effect in treating patients with insomnia of yin deficiency and vigorous fire type， which can improve insomnia， reduce awakening frequency， enhance sleep quality， and have high safety. Its mechanism of action may be related to increasing 5-HT levels and reducing DA levels.