Abstract： Objective： To observe the clinical effect and safety of five-tone therapy combined with oral administration of modified Shiwei Wendan Decoction and auricular point therapy on children with tic disorders（TD）of spleen deficiency and phlegm accumulation type． Methods： A total of 64 cases of children diagnosed with chronic motor or vocal tic disorder（CTD）or Tourette syndrome（TS）of spleen deficiency and phlegm accumulation type，who were treated at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from December 2023 to August 2024，were selected and divided into the trial group and the control group using simple randomization method， with 32 cases in each group．The control group was given the oral administration of modified Shiwei Wendan Decoction and auricular point therapy， and the trial group was additionally treated with five-tone therapy on top of the control group's treatment． Both groups were treated for eight weeks． Yale Global Tic Severity Scale（YGTSS）， Children's Sleep Habits Questionnaire（CSHQ），and Screen for Child Anxiety Related Emotional Disorders（SCARED）in the two groups were evaluated by Generalized Estimation Equation（GEE）before treatment（W0），at the fourth week（W4）， the eighth week（W8），and four weeks after the end of treatment（W12）．Adverse reactions were recorded．Results： YGTSS scores：The group effect was not significant，indicating no noticeable difference between the trial group and the control groups（P＞0.05）． The time effect was significant， with YGTSS scores decreasing at W4， W8， and W12 compared to W0（P＜0.05）．The group×time interaction effect in the two groups showed no significant difference in the change from W0 to W4（P＞0.017）；the decrease in YGTSS scores from W0 to W8 or W12 in the trial group was greater than that in the control group（P＜0.017）．CSHQ scores：The group effect was not significant，indicating no noticeable difference between the trial group and the control group（P＞0.05）．The time effect was significant，with CSHQ scores decreasing at W4， W8， or W12 compared to W0（P＜0.05）． The group×time interaction effect in the two groups showed no significant difference in the change from W0 to W4（P＞0.017）；the decrease in CSHQ scores from W0 to W8 or W12 in the trial group was greater than that in the control group（P＜0.017）．SCARED scores：The group effect was not significant， indicating no noticeable difference between the trial group and the control group（P＞0.05）． Regarding the time effect，there was no significant difference in SCARED scores at W4 compared to W0（P＞0.05）； SCARED scores were decreased at W8 and W12 compared to W0（P＜0.05）．The group time×interaction effect showed no significant difference in the change from W0 to W4， W8， or W12（P＞0.017）． No serious adverse reactions occurred in either group． Conclusion： Five-tone therapy combined with modified Shiwei Wendan Decoction and auricular point therapy has a certain improvement effect on tic symptoms and sleep in children with TD of spleen deficiency and phlegm accumulation type， with high safety and better efficacy compared to oral administration of modified Shiwei Wendan Decoction combined with auricular point therapy alone.