Objective To observe the clinical efficacy of acupuncture plus ZHU's thumb pushing tuina manipulation in treating insomnia.Method A total of 92 insomnia patients were randomized into a treatment group and a control group, 46 cases each. The treatment group was intervened by acupuncture plus ZHU's thumb-pushing manipulation; the control group was treated with acupuncture. They were scored by using Pittsburgh Sleep Quality Index (PSQI) before and after the treatment to evaluate the therapeutic efficacy.Result The total effective rate was 85.7% in the treatment group versus 66.7% in the control group, and the difference was statistically significant (P<0.05). The component and total scores of PSQI were significantly changed after the intervention in both groups (P<0.01,P<0.05). Compared to the control group, the decreases in PSQI scores of sleep quality, sleep duration, use of sleep medications, and daytime dysfunction were more significant in the treatment group (P<0.01,P<0.05).Conclusion Acupuncture plus ZHU's thumb pushing tuina manipulation is an effective approach in treating insomnia.