Abstract: Objective： To study the effect of combined treatment of ear acupoint burying bean and ziziphi spinosae decoction in the treatment of insomnia after stroke and the influence on serum TNF-α. Methods： 60 patients with insomnia after stroke in our hospital from January 2017 to January 2018 were selected and divided into the control group and the study group according to the order of admission. Each group had 30 cases. The control group was treated with ziziphi spinosaea decoction， and the study group was treated with ear acupoint burying beans on the basis of the control group treatment. The clinical effect， the quality of sleep and the level of serum TNF-α were compared between the two groups. Results： The treatment effective rate of the study group was 90.00%， significantly better than that of the control group(66.67%)， and the difference was statistically significant(P<0.05). Before treatment， there was no significant difference between the two groups of patients′ AIS score and serum TNF-α level(P>0.05)； after treatment， the AIS score and serum TNF-α level in the study group were better than those in the control group， the difference was statistically significant(P<0.05). Conclusion： The treatment of ear acupoint burying bean combined with ziziphi spinosae decoction has significant clinical effect to insomnia after stroke， which can improve serum TNF-α level and improve sleep quality.