Objective To study the effect of modified Guizhi Longmu Decoction on serum orexin-A and N- terminal pro-brain natriuretic peptide (NT-proBNP) in patients with insomnia after acute myocardial infarction. Methods 72 patients with insomnia after acute myocardial infarction in our hospital from September 2019 to December 2020 were randomly divided into observation group and control group, with 36 cases in each group. The control group was given routine treatment, while the observation group was given modified Guizhi Longmu Decoction orally on the basis of routine treatment, with a course of 15 days. The levels of AOrexin-A and NT-proBNP were compared between the two groups before and after treatment, and the clinical efficacy was evaluated by Spiegel sleep scale. Results After treatment, the levels of AOrexin-A and NT-proBNP, Spiegel score and other related indexes in the observation group were significantly lower than those in the control group (P < 0.05), and no obvious adverse reactions were found during the study. The total effective rate was 94.44% in the observation group and 86.11% in the control group, and there was no significant difference between the two groups (P > 0.05). 05). conclusion: modified Guizhi longmu decoction can significantly improve AOrexin-A and NT-proBNP levels of insomnia patients after acute myocardial infarction, improve Spiegel score and other related indicators, improve patients' sleep function and facilitate the recovery of heart function, without obvious adverse reactions, which has important clinical significance.