Objective To observe the clinical effect of Heyinganmian Decoction combined with acupoint application in the treatment of Yingwei disorder insomnia. Methods A total of 60 patients with Yingwei disorder insomnia who met the inclusion criteria were randomly divided into two groups, 30 cases in each group. The treatment group took Heyinganmian Decoction orally, 3 times a day, 1 dose a day, combined with acupoint application, 2 times a week, while the control group took estazolam tablets orally, 1 mg once a day before going to bed. Two groups were treated as a course of 30 days. Polysomnography was used to monitor the sleep data of the two groups before and after treatment. The levels of 5-hydroxytryptamine (5-HT), γ-aminobutyric acid (GABA), norepinephrine (NE), dopamine (DA) and melatonin were detected before and after treatment. The clinical symptom score, clinical efficacy, sleep data, neurotransmitter content and adverse reactions after treatment were compared between the two groups before and after treatment. Results The treatment group was significantly better than the control group in TCM syndrome efficacy, PSQI and sleep duration(P<0.05). There were significant differences in the levels of 5-HT, GABA, NE, DA and melatonin between the two groups before and after treatment (P<0.05). The incidence of adverse reactions was 10.0% in the treatment group and 26.7% in the control group (P<0.05). Conclusion Heyinganmian Decoction combined with acupoint application is superior to estazolam in terms of PSQI efficacy, TCM syndrome efficacy, improvement of sleep duration, regulation of neurotransmitters and other aspects, and has significant efficacy and higher safety in the treatment of Yingwei disorder insomnia.