【目的】 基于宫颈 Bishop评分联合胎儿纤维连接蛋白（简称纤连蛋白）检测探讨保产无忧散诱导宫颈成熟的临床价值。 【方法】 选取2023年6月至2024年6月期间在深圳市中医院产科就诊，具备催引产指征的孕足月孕妇115例，采用随机数字 表法将患者随机分为3组，其中西医组35例，中医组及中西医组各40例。西医组采用放置子宫颈扩张球囊或/和静滴缩宫素 引产，中医组仅采用口服保产无忧散引产，中西医组先口服保产无忧散处理，随后放置宫颈扩张球囊或/和静脉滴注缩宫素 进行引产。通过 Bishop 评分联合胎儿纤连蛋白检测评估宫颈成熟度，分析 3 组病例干预前后宫颈成熟度的变化，对比 3 组 在宫颈成熟度、分娩方式、产道损伤、各产程时长（第一、第二、第三及总产程）以及产后 24 h 出血量的差异。 【结果】（1）在分娩方式方面，西医组顺产率为62.86%（22/35），中医组为55.00%（22/40），中西医组为82.50%（33/40），中西 医组的顺产率明显高于中医组，差异有统计学意义（P＜0.05），而中医组与西医组比较差异无统计学意义（P＞0.05）。在产妇 类型（初产妇、经产妇）和产道裂伤情况方面，3组间比较，差异均无统计学意义（P＞0.05）。在孕周、产程和出血量方面，中 西医组的第一产程时长及总产程时长均较中医组和西医组明显缩短，差异均有统计学意义（P＜0.05）；而3组的孕周、第二 产程时长、第三产程时长及产后 24 h出血量比较，差异均无统计学意义（P＞0.05）。（2）在宫颈成熟度方面，3组干预后宫颈 Bishop 评分＜6 分且胎儿纤连蛋白阴性比例均较干预前减少，宫颈 Bishop 评分≥6 分且胎儿纤连蛋白阳性比例均较干预前增 加，差异均有统计学意义（P＜0.01）；干预后组间比较，中西医组宫颈Bishop评分≥6分且胎儿纤连蛋白阳性的比例较中医组 和西医组均显著增加，差异均有统计学意义（P＜0.05）。【结论】 保产无忧散联合子宫颈扩张球囊或/和静滴缩宫素可能更有助 于促宫颈成熟，提升顺产率，并减少第一产程和总产程时间，为临床分娩方案的优化提供了重要参考。

Objective To evaluate the clinical efficacy of Baochan Wuyou San in promoting cervical ripening based on cervical Bishop score combined with fetal fibronectin （fFN） detection. Methods A total of 115 full-term pregnant women with indications for labor induction， admitted to the Department of Obstetrics at Shenzhen Traditional Chinese Medicine Hospital between June 2023 and June 2024，were enrolled and randomly divided into three groups using a random number table：35 cases in the western medicine group，and 40 cases each in the traditional Chinese medicine （TCM） group and the integrated Chinese-western medicine group. The western medicine group received induction via cervical dilation balloon placement and/or intravenous infusion of oxytocin.The TCM group received oral administration of Baochan Wuyou San alone for induction. The integrated group received oral use of Baochan Wuyou San followed by cervical dilation balloon placement and/or intravenous of infusion oxytocin. Cervical maturity was assessed using Bishop score combined with fFN detection. Changes in cervical maturity before and after intervention were analyzed，and comparisons were made among the three groups regarding cervical maturity， delivery mode， birth canal injury， durations of various stages of labor （first， second，third，and overall stages），and 24-hour postpartum blood loss. Results（1） Regarding delivery mode， the vaginal delivery rates were 62.86%（22/35） in the western medicine group， 55.00%（22/40） in the TCM group， and 82.50% （33/40） in the integrated group. The vaginal delivery rate in the integrated group was significantly higher than that in the TCM group （P＜0.05），and there were no statistically significant differences between the TCM group and western medicine group （P＞0.05）. There were no statistically significant differences among the three groups in terms of maternal type （primipara，multipara） and birth canal laceration（P＞0.05）. In terms of gestational weeks，labor stages，and blood loss，the durations of the first stage and total labor in the integrated group were significantly shorter than those in the TCM and western medicine groups （P＜0.05）. However， no significant differences were found among the three groups in gestational weeks， durations of the second and third stages of labor，or 24-hour postpartum blood loss （P＞0.05）.（2） Regarding cervical maturity， the proportion of cases with Bishop scores＜6 and negative fFN was decreased after intervention in all three groups， while the proportion with Bishop scores ≥ 6 and positive fFN was increased，with statistically significant differences （P＜0.01）. After intervention，the integrated group showed a significantly higher proportion of cases with Bishop scores ≥ 6 and positive fFN was compared to the TCM and western medicine groups （P＜0.05）. Conclusion The combination of Baochan Wuyou San with cervical dilation balloon and/or intravenous infusion of oxytocin may be more effective in promoting cervical ripening，increasing the rate of vaginal delivery，and reducing the duration of the first and total stages of labor. This study provides valuable insights for optimizing clinical delivery strategies.

R271.9

广东省中医药局科研项目（编号：20231301）；深圳市中医院“3030”计划中医临床研究项目（编号：2022042911）