Objective: To investigate whether the improvement of exosomal vesicle miRNA in rats with spleen-kidney yang deficiency syndrome by Angelica sinensis ginger mutton soup is related to the mechanism of energy metabolism. Methods: A spleen-kidney yang deficiency syndrome model was established using maternal-fetal separation and senna leaf gavage. Rat rectal temperature and serum insulin levels were measured via ELISA. Exosomal RNA was extracted, and its concentration was determined, integrity verified, and small RNA sequenced. Differential miRNAs and their target gene functions were analyzed using bioinformatics. Results: The model group exhibited lower body temperature ,T3 and insulin sensitivity index compared to the normal control group. After intervention with Angelica sinensis ginger mutton soup, these parameters showed significant improvement. miRNA sequencing revealed 6 annotated miRNAs with differential expression in exosomes across all groups, among which rno-let-7b-5p had the highest expression level. rno-miR-122-5p was identified as a key differential miRNA, which demonstrated validated regulatory relationships with energy metabolism-related target genes such as Gys1, Slc7a1, Aldoa, and Fasn. Functional enrichment analysis indicated that the target genes of differential miRNAs were significantly enriched in metabolic pathways including AMPK signaling, insulin signaling, and fatty acid biosynthesis. Conclusion: This study confirms that Angelica sinensis ginger mutton soup can improve energy metabolism disorders in rats with spleen-kidney yang deficiency syndrome by regulating the expression of miRNAs in exosomes and targeting energy metabolism-related genes and signaling pathways.