In response to the advantages of compactness and high efficiency of spiral elastic tube heat exchanger and its easy-to-vibrate characteristics, this study aims to further improve its heat transfer efficiency by utilizing fluid-induced vibration-enhanced heat transfer technology, so a design scheme of reverse baffle spiral tube heat exchanger (RB-STHE) is proposed to enhance the turbulence characteristics of the shell-side fluid by installing spiral baffles, thus promoting the vibration of the spiral tube. In this study, four new types of the RB-STHE (Model A, B, C, and D) were used as research objects, and the two-way fluid–structure coupling calculation method (using CFX and Transient Structure software) was adopted to systematically investigate the effect of fluid-induced spiral tube vibration on the comprehensive heat transfer coefficient (HTC) of the RB-STHE under different flow velocities and structure schemes, and based on the research data, the objective of no reduction in the comprehensive HTC and savings in the use of materials is taken as the goal, so as to put forward the improved Model C-1. The results show that: although the fluid-induced spiral tube vibration can effectively improve the HTC of the spiral tube, it also increases the pressure drop in the RB-STHE, and the larger the amplitude, the higher the degree of influence; among them, Model C is most affected by the spiral tube vibration, and its HTC and pressure drop are maximally enhanced by 6.33% and 5.85%, respectively. The change in the number of baffles has a significant effect on the comprehensive HTC of the RB-STHE. Compared to the Model D without a spiral baffle, the maximum improvement in the comprehensive HTC of Model C with one spiral baffle installed in the RB-STHE is 14%, while the Model A with four spiral baffles and the Model B with two spiral baffles have a maximum reduction in the comprehensive HTC of 20% and 3%, respectively. In addition, compared to Model C, the structure improved Model C-1 significantly reduces the size of the spiral baffle while effectively maintaining the comprehensive HTC of the RB-STHE, making the structure more reasonable, which provides a reference for heat exchanger design.