Abstract： Objective： To observe the clinical effect of modified Guipi Decoction combined with Esazolam Tablets for perimenopausal insomnia of dual deficiency of the heart-spleen type. Methods： A total of 60 cases of patients with perimenopausal insomnia of dual deficiency of the heart-spleen type were divided into the control group and the treatment group according to the random number table method，with 30 cases in each group. The control group was treated with Esazolam Tablets，and the treatment group was additionally treated with modified Guipi Decoction on the basis of the control group. Traditional Chinese medicine (TCM) syndrome scores，Pittsburgh Sleep Quality Index (PSQI) and sex hormone levels [estradiol (E2)， luteinizing hormone (LH) and follicle-stimulating hormone (FSH)] before and after treatment were compared between the two groups； clinical effects and incidence of adverse reactions were analyzed. Results：The total effective rate was 96.67% in the treatment group and 76.67% in the control group，the difference being significant (P＜0.05). After treatment， the scores of TCM syndromes such as profuse dreaming and restless sleep， palpitation， forgetfulness and dizziness in the two groups were decreased when compared with those before treatment (P＜0.05)，and the scores above in the treatment group were lower than those in the control group (P＜0.05). After treatment， PSQI scores of sleep quality， time of falling asleep，sleep time，sleep efficiency，sleep disorders，hypnotic drugs，daytime dys function，etc.， and the total PSQI scores in the two groups were decreased when compared with those before treatment (P＜0.05)， and the above scores in the treatment group were lower than those in the control group (P＜ 0.05). After treatment， serum E2 levels in the two groups were increased when compared with those before treatment (P＜0.05)， and the levels of LH and FSH were decreased when compared with those before treatment (P＜0.05)；the level of E2 in the treatment group was higher than that in the control group (P＜0.05)，and the levels of LH and FSH in the treatment group were lower than those in the control group (P＜0.05). The incidence of adverse reactions was 3.33% in the treatment group and 20.00% in the control group， the difference being significant (P＜0.05). Conclusion： Modified Guipi Decoction combined with Esazolam Tablets has a significant effect in the treatment of perimenopausal insomnia of dual deficiency of the heart-spleen type，which can improve TCM syndromes and sleep quality and regulate the levels of sex hormones，with relatively few adverse reactions.