Abstract： Objective： To observe the clinical efficacy of Yishen Antai Formula combined with low molecular weight heparin（LMWH）and low-dose Aspirin in treating prethrombotic state of recurrent abortion，and its effects on serum tissue-type plasminogen activator（t-PA）and p-selectin levels．Methods：A total of 98 patients with recurrent abortion treated at Puyang Anyang District Hospital from January 2022 to June 2023 were divided into the western medicine group（49 cases）and the integrated Chinese-western medicine group（49 cases）using the random number table method． After exclusions， 47 cases remained in the western medicine group and 46 cases in the integrated Chinese - western medicine group． The western medicine group received LMWH and low-dose Aspirin， while the integrated Chinese-western medicine group received additional Yishen Antai Formula． Parameters including plasma protein C，antithrombin Ⅲ，protein S activity，platelet α-granule membrane glycoprotein-140（GMP-140），platelet factor 4， soluble vascular endothelial growth factor receptor 1（sFlt-1）， hypoxia-inducible factor 1α， p-selectin， vascular endothelial growth factor（VEGF）， t-PA， whole blood low-shear reduced viscosity， fibrinogen， plasma viscosity，whole blood high-shear reduced viscosity，uterine artery resistance index，pulsatility index，peak systolic velocity/diastolic velocity ratio， as well as pregnancy rate， successful delivery rate， and spontaneous abortion rate within one year were compared between groups．Results：After treatment，the activity of antithrombin Ⅲ，protein S， and protein C in both groups increased compared to before treatment（P＜0.05），and the activity of antithrombin Ⅲ， protein S，and protein C in the integrated Chinese-western medicine group was higher than that in the western medicine group（P＜0.05）．After treatment，the levels of platelet factor 4，GMP-140，p-selectin，and t-PA in both groups decreased compared to before treatment（P＜0.05）， and the levels of the four indicators in the integrated Chinesewestern medicine group were lower than those in the western medicine group（P＜0.05）．After treatment，the VEGF levels in both groups increased compared to before treatment（P＜0.05），and the VEGF level in the integrated Chinesewestern medicine group was higher than that in the western medicine group（P＜0.05）； the levels of sFlt-1 and hypoxia-inducible factor 1α in both groups decreased compared to before treatment（P＜0.05），and the levels of both indicators in the integrated Chinese-western medicine group were lower than those in the western medicine group（P＜ 0.05）． After treatment， the levels of whole blood low-shear reduced viscosity， fibrinogen， plasma viscosity， and whole blood high-shear reduced viscosity in both groups decreased compared to before treatment（P＜0.05），and the levels of various indicators in the integrated Chinese-western medicine group were lower than those in the western medicine group（P＜0.05）．After treatment，the uterine artery resistance index，pulsatility index，and peak systolic velocity/diastolic flow velocity levels in both groups decreased compared to before treatment（P＜0.05），and the levels of these indicators in the integrated Chinese-western medicine group were lower than those in the western medicine group（P＜0.05）．The pregnancy rate within one year was 91.30%（42/46）in the integrated Chinese-western medicine group，while was 78.72%（37/47）in the control group，there being no significant difference between the two groups （P＞0.05）. The successful delivery rate was 92.86%（39 / 42） in the integrated Chinese-western medicine group， higher than that of 75.68%（28/37）in the western medicine group ，and the spontaneous abortion rate [7.14%（3/42）] was lower than that of the western medicine group [24.32%（9 / 37）]， differences being significant（P＜0.05）． Conclusion： Yishen Antai Formula combined with LMWH and low-dose Aspirin can regulate coagulation factors， promote angiogenesis，improve prethrombotic state，hemodynamics and hemorheology，thereby improving pregnancy outcomes in recurrent abortion patients with prethrombotic state.