阿坝州育龄期妇女口腔疾病负担水平和趋势研究进展分析

Analysis of Research Progress on the Burden Level and Trends of Oral Diseases among Women of Childbearing Age in Aba Prefecture

摘要: 目的：本研究旨在遵循全球疾病负担研究框架，全面评估阿坝州育龄期妇女主要口腔疾病的患病水平疾病负担(以伤残调整寿命年DALYS计)及其变化趋势，深入剖析社会文化、经济环境等关键影响因素并评估现有干预措施的认知与成效，为构建符合地区特点的口腔健康管理服务体系提供科学决策依据。方法：采用横断面研究与回顾性分析相结合的设计。以2023~2025年在阿坝州人民医院及部分县级医疗机构就诊的育龄期妇女(15~49岁)为主要研究队列，通过(藏汉双语)电子问卷和口腔临床检查收集个体数据。数据维度涵盖人口社会学特征、口腔健康知识–态度–行为、疾病史、以及基于国际标准(如ADA龋风险评估、PRC牙周风险评估)的风险分级。结合州、省、国家三级卫生统计数据及GBD数据库，对患病率、发病率及DALYs进行估算与比较分析。运用多元回归模型探究影响口腔健康的关键因素。结果：阿坝州育龄期妇女龋病和牙周病患病率显著高于四川省及全国平均水平，且呈现低龄化趋势。经估算，其口腔疾病所致的DALYs负担较重，主要由未经治疗的龋齿和严重牙周炎构成。多维分析显示，地理可及性差、家庭人均收入低、口腔健康素养不足是主要风险因素。民族文化(如特定饮食习惯)和宗教观念在一定程度上影响了居民对口腔疾病的认知和就医行为。尽管近年来健康宣教活动提升了部分人群的认知，但从认知到行为的转化率低，预防性干预(如孕前检查、定期洁治)的接受度和参与度仍处于较低水平。结论：阿坝州育龄期妇女面临着严峻的口腔疾病负担，其背后是经济、地理、文化等多重因素交织作用的结果。当前“以治疗为中心的模式”难以应对挑战。亟需建立一个“以预防为先、风险分级、家–校–医–社联动”为核心，并深度融合藏汉双语及“互联网+”技术的口腔健康管理服务体系，以精准提升该地区妇女儿童的口腔健康水平。

Abstract: Objective: This study, guided by the Global Burden of Disease (GBD) framework, aimed to comprehensively assess the prevalence, disease burden (in Disability-Adjusted Life Years, DALYs), and trends of major oral diseases among women of childbearing age in Aba Prefecture, a unique multi-ethnic region in China. We also analyzed key socio-cultural and economic determinants and evaluated the effectiveness of current interventions to provide an evidence base for targeted oral health policy. Methods: A mixed-methods design combining a cross-sectional study with retrospective analysis was employed. The study cohort comprised women of childbearing age (15~49 years) seeking care from 2023~2025 at the Aba Prefecture People’s Hospital and affiliated county-level clinics. Data on sociodemographic characteristics, oral health Knowledge, Attitude, and Practices (KAP), and medical history were collected via a bilingual (Tibetan-Chinese) electronic questionnaire. Clinical oral examinations were conducted, and risk levels were stratified using international standards. Disease prevalence, incidence, and DALYs were estimated and compared using regional, provincial, national, and GBD database statistics. Multivariate regression models were used to identify key influencing factors. Results: The prevalence of dental caries and periodontal disease among women of childbearing age in Aba Prefecture was significantly higher than provincial and national averages, with a trend towards earlier onset. The estimated DALYs burden from oral diseases was substantial, primarily driven by untreated caries and severe periodontitis. Multivariate analysis revealed that poor geographic accessibility, low household income, and inadequate oral health literacy were significant risk factors. Socio-cultural factors, including specific dietary habits and traditional beliefs, influenced disease perception and healthcare-seeking behaviors. While health education initiatives increased awareness, the knowledge-to-behavior conversion rate remained low, with persistently poor uptake of preventive services. Conclusion: Women of childbearing age in Aba Prefecture face a severe oral disease burden, shaped by a complex interplay of economic, geographic, and cultural factors. The current treatment-centric healthcare model is inadequate to address these multifaceted challenges. There is an urgent need for an integrated oral health management system centered on prevention, risk stratification, and a coordinated “home-school-clinic-community” linkage model. This system must be culturally competent, incorporating bilingual (Tibetan-Chinese) services and leveraging “Internet+” technologies to effectively improve oral health outcomes for women and children in this underserved region.