Abstract：Objective：To observe the clinical efficacy of LI′s Bushen Guchong Decoction in the treatment of early threatened abortion （TA） of spleen-kidney deficiency type. Methods：A total of 100 patients with early TA who were diagnosed and treated at the First People′s Hospital of Zhengzhou from June 2023 to June 2025 were enrolled and divided into a control group and an observation group using the random number table method， with 50 cases in each group. The control group was treated with conventional western medicine，while the observation group was additionally treated with LI′s Bushen Guchong Decoction on the basis of the control group. The clinical efficacy，traditional Chinese medicine syndrome scores， ultrasonographic imaging indicators [subchorionic hematoma （SCH） level and SCH/gestational sac（ GS） ratio]，sex hormone levels [serum progesterone（ P），β-human chorionic gonadotropin（ β-HCG）， estradiol （E2）]， and quality of life [Short Form 36 Health Survey （SF-36）] scores were compared between the two groups. Results： The total effective rate was 92.00% （46/50） in the observation group and 76.00% （38/50） in the control group，and the difference between the two groups was statistically significant （P＜0.05）. After treatment，the traditional Chinese medicine syndrome scores in both groups decreased compared with those before treatment，and the scores in the observation group were lower than those in the control group （P＜0.05）. After treatment，the SCH levels and SCH/GS ratios in both groups decreased compared with those before treatment， and both indicators in the observation group were lower than those in the control group （P ＜ 0.05）. After treatment， the levels of serum P， β -HCG，and E2 in both groups increased compared with those before treatment，and the levels of serum P，β-HCG， and E2 in the observation group were higher than those in the control group （P＜0.05）. After treatment，the scores of physiological function，role-physical，bodily pain，general health，vitality，social function，role-emotional，and mental health in the SF-36 scale in both groups increased compared with those before treatment，and all scores in the observation group were higher than those in the control group （P＜0.05）. No significant adverse reactions occurred in either group during treatment. Conclusion： The combination of LI′s Bushen Guchong Decoction and conventional western medicine for early TA of spleen-kidney deficiency type can enhance clinical efficacy， and improve patients′ traditional Chinese medicine syndrome manifestations，quality of life，and sex hormone levels.