To investigate the clinical efficacy and mechanism of Peiyuan Huoxue Shoutai Decoction（培元活血寿胎方）combined with enoxaparine in the treatment of recurrent spontaneous abortion associated with antiphospholipid syndrome.

Ninety-six patients with recurrent spontaneous abortion associated with antiphospholipid syndrome admitted to the hospital between January 2021 and June 2023 who fulfilled the inclusion and exclusion criteria were enrolled，and classified into two groups using numerical parity method，each with 48 cases. The control group was given enoxaparin，and the observation group was given Peiyuan Huoxue Shoutai Decoction combined with enoxaparine. Then the clinical efficacy，TCM syndrome scores（vaginal bleeding，soreness and weakness of waist and knees，pale tongue，dizziness and tinnitus，frequent urination at night），coagulation function parameter，negative rate of antiphospholipid antibodies，pregnancy outcomes and adverse reaction rate were compared between two groups.

The observation group reported a higher clinical efficacy rate compared to the control group（91.67% vs 77.08%，P<0.05）. The improvement in TCM syndrome scores including vaginal bleeding，soreness and weakness of waist and knees，pale tongue，dizziness and tinnitus，frequent urination at night was more notable in the observation group than that in the control group after treatment（P<0.05）. The reduction in D-dimer（D-D）and fibrinogen（FIB）and the increase in prothrombin time（PT）and activated partial thromboplastin time（APTT）were more remarkable in the observation group than those in the control group（P<0.05）. The total conversion rate of antiphospholipid antibodies including anticardiolipin antibody，lupus anticoagulant and anti-β2 glycoprotein-I antibody was 91.67% in the observation group，which was higher than that（75.00%）in the control group（P<0.05）. Tocolytic success rate was 83.33% in the observation group，which was higher than that（58.33%）in the control group（P<0.05）. The total adverse reaction rate during treatment yielded no statistical difference between two groups［4.17%（2/48）vs 10.42%（5/48）］（P>0.05）.

The application of Peiyuan Huoxue Shoutai Decoction combined with enoxaparine for patients with recurrent spontaneous abortion associated with antiphospholipid syndrome can effectively ameliorate the clinical symptoms，improve the coagulation function，enhance the conversion rate of antiphospholipid antibody and increase the tocolytic success rate，which has a good safety profile and is worthy of recommendation.