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Article(id=1241329580041097542, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241329570129956900, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202503037, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1740931200000, receivedDateStr=2025-03-03, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773885634670, onlineDateStr=2026-03-19, pubDate=1752076800000, pubDateStr=2025-07-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773885634670, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773885634670, creator=13701087609, updateTime=1773885634670, updator=13701087609, issue=Issue{id=1241329570129956900, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='13', pageStart='2305', pageEnd='2496', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773885632307, creator=13701087609, updateTime=1773885763730, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241330121425080472, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241329570129956900, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241330121425080473, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241329570129956900, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2323, endPage=2327, ext={EN=ArticleExt(id=1241329580410196316, articleId=1241329580041097542, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Disease burden and projection of low back pain in China from 1990 to 2021, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the trends of low back pain (LBP) burden in China from 1990 to 2021 and project future trends through 2036.

Methods

Data on prevalence, incidence, and disability-adjusted life years (DALYs) were extracted from the Global Burden of Disease 2021 database. Joinpoint regression analyzed trends from 1990 to 2021, while Bayesian age-period-cohort modeling projected trends from 2022 to 2036.

Results

From 1990 to 2021, while total LBP cases increased in China, age-standardized prevalence, incidence, and DALY rates showed overall declining trends. Females consistently bore higher burden than males. Projections indicate age-standardized incidence rates will increase for males but decrease for females by 2036.

Conclusion

China demonstrated reduced LBP burden indicators during 1990-2021, with persistently higher burden among females. Projections suggest diverging future trends between genders, with rising male incidence but declining female incidence.

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目的

分析1990—2021年中国腰痛（LBP）负担的趋势，并预测至2036年的未来趋势。

方法

从全球疾病负担（GBD）2021数据库中获取中国腰痛的患病率、发病率及伤残调整生命年数据。采用joinpoint回归模型分析1990—2021年的趋势，并使用贝叶斯年龄-时期-队列模型预测2022—2036年的趋势。

结果

1990—2021年，中国腰痛的总病例数增加，但年龄标化患病率、年龄标化发病率和年龄标化伤残调整生命年率整体呈下降趋势。女性的疾病负担高于男性。贝叶斯年龄-时期-队列模型预测到2036年，男性腰痛的年龄标化发病率将增加，而女性的年龄标化发病率将下降。

结论

1990—2021年，中国腰痛的疾病负担指数在逐年降低，女性的疾病负担总体大于男性。据模型预测，未来女性发病率将下降，而男性的发病率将上升。

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樊效鸿，E-mail:：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=Wa1S0ZIBvvqr1mpoz29Y2g==, magXml=nUzyX5vfz6tL0KQLwfe9tg==, pdfUrl=null, pdf=HyCrNXo6JdnS9+rF3TKxgg==, pdfFileSize=642783, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=L+d6F3KIF0pPNxP/GX/mTA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=VAMVoa6piNt+GwajGfY0JQ==, mapNumber=null, authorCompany=null, fund=null, authors=

严佳宝（1996—），男，博士在读，研究方向：脊柱疾病研究

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严佳宝（1996—），男，博士在读，研究方向：脊柱疾病研究

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严佳宝（1996—），男，博士在读，研究方向：脊柱疾病研究

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Health Sci Rep,2023, 6(7): e1389., articleTitle=Low back pain in a sample of Syrian pregnant women: A cross-sectional study, refAbstract=null), Reference(id=1241329768084329400, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, doi=null, pmid=null, pmcid=null, year=2022, volume=35, issue=1, pageStart=177, pageEnd=184, url=null, language=null, rfNumber=[11], rfOrder=10, authorNames=Lu YM, Chen CH, Lue YJ, journalName=Journal of Back and Musculoskeletal Rehabilitation, refType=null, unstructuredReference=Lu YM, Chen CH, Lue YJ. A cross-sectional study of disability and quality of Life in patients with low back pain: Focus on sex and gender[J] . 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Disease burden of musculoskeletal disorders in China from 1990 to 2019[J] . Chinese Journal of Disease Control & Prevention, 2023, 27(6): 655-661.(In Chinese), articleTitle=Disease burden of musculoskeletal disorders in China from 1990 to 2019, refAbstract=null), Reference(id=1241329770500248521, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, doi=null, pmid=null, pmcid=null, year=2016, volume=93, issue=null, pageStart=82, pageEnd=87, url=null, language=null, rfNumber=[13], rfOrder=13, authorNames=Li SS, Meng LH, Chiolero A, journalName=Preventive Medicine, refType=null, unstructuredReference=Li SS, Meng LH, Chiolero A, et al. Trends in smoking prevalence and attributable mortality in China, 1991–2011[J] . 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Trends of body mass index and waist circumference of children and adolescents aged 6-17 years in China from 1982 to 2016[J] . Health Research, 2025, 54(2): 175-180.(In Chinese), articleTitle=Trends of body mass index and waist circumference of children and adolescents aged 6-17 years in China from 1982 to 2016, refAbstract=null), Reference(id=1241329770940650469, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, doi=null, pmid=null, pmcid=null, year=2017, volume=30, issue=5, pageStart=315, pageEnd=322, url=null, language=null, rfNumber=[15], rfOrder=16, authorNames=Zhai Y, Fang HY, Yu WT, journalName=Biomedical and Environmental Sciences, refType=null, unstructuredReference=Zhai Y, Fang HY, Yu WT, et al. Changes in waist circumference and abdominal obesity among Chinese adults over a ten-year period[J] . Biomedical and Environmental Sciences, 2017, 30(5): 315-322., articleTitle=Changes in waist circumference and abdominal obesity among Chinese adults over a ten-year period, refAbstract=null)], funds=[Fund(id=1241329766494688080, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, awardId=2024zd025, language=CN, fundingSource=四川省中医药管理局重点科研项目(2024zd025), fundOrder=null, country=null), Fund(id=1241329766612128600, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, awardId=川健研2025-501, language=CN, fundingSource=四川省保健科研项目(川健研2025-501), fundOrder=null, country=null), Fund(id=1241329766700208993, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, awardId=2023KCY01, language=CN, fundingSource=成都中医药大学临床医学院研究生科研创新实践项目(2023KCY01), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241329762120028658, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, xref=null, ext=[AuthorCompanyExt(id=1241329762128417268, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, companyId=1241329762120028658, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China), AuthorCompanyExt(id=1241329762132611573, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, companyId=1241329762120028658, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=成都中医药大学附属医院，四川 成都 610075)])], figs=[ArticleFig(id=1241329765194453744, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, language=EN, label=Figure 1, caption=Age distribution of the burden of low back pain by sex in 2021

A: Number of cases; B: Prevalence rate; C: Number of new cases; D: Incidence rate

, figureFileSmall=AuXAJcq0tMcsIiph2MHW7Q==, figureFileBig=L+d6F3KIF0pPNxP/GX/mTA==, tableContent=null), ArticleFig(id=1241329765316088568, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, language=CN, label=图1, caption=2021年按性别划分的腰痛疾病负担的年龄分布

注：A患病人数；B患病率；C发病人数；D发病率。

, figureFileSmall=AuXAJcq0tMcsIiph2MHW7Q==, figureFileBig=L+d6F3KIF0pPNxP/GX/mTA==, tableContent=null), ArticleFig(id=1241329765454500615, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, language=EN, label=Figure 2, caption=BAPC predicted trends of age-standardized incidence rate (ASIR) of low back pain in China from 2022 to 2036

A: Male; B: Female

, figureFileSmall=chLTBEozuQQFA0SCRDsxDA==, figureFileBig=br0frx0UUx23mH+MKyJkmg==, tableContent=null), ArticleFig(id=1241329765597106957, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, language=CN, label=图2, caption=2022—2036年中国腰痛ASIR的BAPC预测趋势

注：A男性；B女性。

, figureFileSmall=chLTBEozuQQFA0SCRDsxDA==, figureFileBig=br0frx0UUx23mH+MKyJkmg==, tableContent=null), ArticleFig(id=1241329765701964568, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, language=EN, label=Table 1, caption=

Prevalence and incidence of low back pain in 1990 and 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
项目病例数(95%CI)
1990年2021年
患病
男26 518 611 (22 932 828～30 437 569)39 148 537 (33 850 361～44 326 367)
女41 762 395 (36 226 090～47 518 758)60 945 208 (52 941 431～68 505 911)
总数68 281 007 (59 158 022～77 853 897)100 093 746 (87 128 173～113 014 316)
发病
男11 935 321 (10 375 736～13 642 026)17 158 052 (14 905 295～19 511 511)
女17 908 648 (15 662 630～20 301 615)26 216 943 (22 616 551～29 717 547)
总数29 843 970 (26 065 824～34 012 369)43 374 995 (37 494 376～49 159 184)
), ArticleFig(id=1241329765831988003, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, language=CN, label=表1, caption=

1990和2021年腰痛的患病病例数和新发病例数

, figureFileSmall=null, figureFileBig=null, tableContent=
项目病例数(95%CI)
1990年2021年
患病
男26 518 611 (22 932 828～30 437 569)39 148 537 (33 850 361～44 326 367)
女41 762 395 (36 226 090～47 518 758)60 945 208 (52 941 431～68 505 911)
总数68 281 007 (59 158 022～77 853 897)100 093 746 (87 128 173～113 014 316)
发病
男11 935 321 (10 375 736～13 642 026)17 158 052 (14 905 295～19 511 511)
女17 908 648 (15 662 630～20 301 615)26 216 943 (22 616 551～29 717 547)
总数29 843 970 (26 065 824～34 012 369)43 374 995 (37 494 376～49 159 184)
), ArticleFig(id=1241329765924262703, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, language=EN, label=Table 2, caption=

ASPR, ASIR, and ASDR of low back pain in 1990 and 2021, and their trends

, figureFileSmall=null, figureFileBig=null, tableContent=
项目年龄标准化率（1/10万）（95%CI）AAPC(%)
1990年2021年
ASPR
男5 007.60 (4 329.54～5 663.31)4 282.30 (3 759.62～4 838.55)-0.49*
女8 247.28 (7 164.44～9 292.73)6 381.38 (5 567.92～7 153.22)-0.79*
总数6 635.49 (5 770.68～7 472.8)5 342.10 (4 660.41～5 976.28)-0.66*
ASIR
男2 225.35 (1 938.91～2 522.85)1 901.62 (1 673.22～2 155.4)-0.50*
女3 495.28 (3 072.89～3 934.17)2 779.16 (2 436.19～3 121.16)-0.71*
总数2 859.38 (2 508.61～3 225.53)2 342.46 (2 058.05～2 639.32)-0.61*
ASDR
男571.73 (402.17～779.32)488.36 (346.52～657.58)-0.50*
女925.83 (657.88～1 253.35)716.15 (506.26～959.84)-0.79*
总数749.03 (530.01～1 013.84)603.03 (427.63～810.16)-0.66*
), ArticleFig(id=1241329766054286132, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, language=CN, label=表2, caption=

1990和2021年腰痛的ASPR、ASIR和ASDR及其趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
项目年龄标准化率（1/10万）（95%CI）AAPC(%)
1990年2021年
ASPR
男5 007.60 (4 329.54～5 663.31)4 282.30 (3 759.62～4 838.55)-0.49*
女8 247.28 (7 164.44～9 292.73)6 381.38 (5 567.92～7 153.22)-0.79*
总数6 635.49 (5 770.68～7 472.8)5 342.10 (4 660.41～5 976.28)-0.66*
ASIR
男2 225.35 (1 938.91～2 522.85)1 901.62 (1 673.22～2 155.4)-0.50*
女3 495.28 (3 072.89～3 934.17)2 779.16 (2 436.19～3 121.16)-0.71*
总数2 859.38 (2 508.61～3 225.53)2 342.46 (2 058.05～2 639.32)-0.61*
ASDR
男571.73 (402.17～779.32)488.36 (346.52～657.58)-0.50*
女925.83 (657.88～1 253.35)716.15 (506.26～959.84)-0.79*
总数749.03 (530.01～1 013.84)603.03 (427.63～810.16)-0.66*
), ArticleFig(id=1241329766175920958, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, language=EN, label=Table 3, caption=

Joinpoint regression trends of the burden of low back pain in China from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
性别年份（年）ASPRASIRASDR
APC(%)P值APC(%)P值APC(%)P值
男
1990—1994-2.19<0.001-2.08<0.001-2.15<0.001
1994—2001-0.100.002-0.10.001-0.15<0.001
2001—2010-0.64<0.001-0.65<0.001-0.67<0.001
2010—2015-0.43<0.001-0.43<0.001-0.42<0.001
2015—20190.69<0.0010.58<0.0010.67<0.001
2019—2021-0.370.055-0.320.45-0.350.04
女
1990—1994-4.54<0.001-4.00<0.001-4.54<0.001
1994—2001-0.150.009-0.160.002-0.160.01
2001—2014-0.53<0.001-0.47<0.001-0.51<0.001
2014—20210.28<0.0010.23<0.0010.24<0.001
总体
1990—1994-3.62<0.001-3.23<0.001-3.61<0.001
1994—2001-0.140.03-0.150.013-0.130.002
2001—2014-0.55<0.001-0.52<0.001-0.55<0.001
2014—20210.33<0.0010.28<0.0010.29<0.001
), ArticleFig(id=1241329766272389957, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241329580041097542, language=CN, label=表3, caption=

1990—2021年中国腰痛疾病负担的joinpoint回归趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
性别年份（年）ASPRASIRASDR
APC(%)P值APC(%)P值APC(%)P值
男
1990—1994-2.19<0.001-2.08<0.001-2.15<0.001
1994—2001-0.100.002-0.10.001-0.15<0.001
2001—2010-0.64<0.001-0.65<0.001-0.67<0.001
2010—2015-0.43<0.001-0.43<0.001-0.42<0.001
2015—20190.69<0.0010.58<0.0010.67<0.001
2019—2021-0.370.055-0.320.45-0.350.04
女
1990—1994-4.54<0.001-4.00<0.001-4.54<0.001
1994—2001-0.150.009-0.160.002-0.160.01
2001—2014-0.53<0.001-0.47<0.001-0.51<0.001
2014—20210.28<0.0010.23<0.0010.24<0.001
总体
1990—1994-3.62<0.001-3.23<0.001-3.61<0.001
1994—2001-0.140.03-0.150.013-0.130.002
2001—2014-0.55<0.001-0.52<0.001-0.55<0.001
2014—20210.33<0.0010.28<0.0010.29<0.001
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1990—2021年中国腰痛的疾病负担及预测
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严佳宝 , 周芮君 , 冷川 , 樊效鸿
现代预防医学 | 流行病与统计方法 2025,52(13): 2323-2327
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现代预防医学 | 流行病与统计方法 2025, 52(13): 2323-2327
1990—2021年中国腰痛的疾病负担及预测
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严佳宝, 周芮君, 冷川, 樊效鸿
作者信息
  • 成都中医药大学附属医院，四川 成都 610075

    • 严佳宝（1996—），男，博士在读，研究方向：脊柱疾病研究

通讯作者:

樊效鸿，E-mail:：
Disease burden and projection of low back pain in China from 1990 to 2021
Jia-bao YAN, Rui-jun ZHOU, Chuan LENG, Xiao-hong FAN
Affiliations
  • Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
出版时间: 2025-07-10 doi: 10.20043/j.cnki.MPM.202503037
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摘要
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目的

分析1990—2021年中国腰痛（LBP）负担的趋势，并预测至2036年的未来趋势。

方法

从全球疾病负担（GBD）2021数据库中获取中国腰痛的患病率、发病率及伤残调整生命年数据。采用joinpoint回归模型分析1990—2021年的趋势，并使用贝叶斯年龄-时期-队列模型预测2022—2036年的趋势。

结果

1990—2021年，中国腰痛的总病例数增加，但年龄标化患病率、年龄标化发病率和年龄标化伤残调整生命年率整体呈下降趋势。女性的疾病负担高于男性。贝叶斯年龄-时期-队列模型预测到2036年，男性腰痛的年龄标化发病率将增加，而女性的年龄标化发病率将下降。

结论

1990—2021年，中国腰痛的疾病负担指数在逐年降低，女性的疾病负担总体大于男性。据模型预测，未来女性发病率将下降，而男性的发病率将上升。

腰痛  /  全球疾病负担  /  年龄标化患病率  /  年龄标化发病率  /  年龄标化伤残调整生命年率
Objective

To analyze the trends of low back pain (LBP) burden in China from 1990 to 2021 and project future trends through 2036.

Methods

Data on prevalence, incidence, and disability-adjusted life years (DALYs) were extracted from the Global Burden of Disease 2021 database. Joinpoint regression analyzed trends from 1990 to 2021, while Bayesian age-period-cohort modeling projected trends from 2022 to 2036.

Results

From 1990 to 2021, while total LBP cases increased in China, age-standardized prevalence, incidence, and DALY rates showed overall declining trends. Females consistently bore higher burden than males. Projections indicate age-standardized incidence rates will increase for males but decrease for females by 2036.

Conclusion

China demonstrated reduced LBP burden indicators during 1990-2021, with persistently higher burden among females. Projections suggest diverging future trends between genders, with rising male incidence but declining female incidence.

Low back pain  /  China  /  Global burden of disease  /  Age-standardized prevalence rate  /  Age-standardized incidence rate  /  Age-standardized DALY rate
严佳宝, 周芮君, 冷川, 樊效鸿. 1990—2021年中国腰痛的疾病负担及预测. 现代预防医学, 2025 , 52 (13) : 2323 -2327 . DOI: 10.20043/j.cnki.MPM.202503037
Jia-bao YAN, Rui-jun ZHOU, Chuan LENG, Xiao-hong FAN. Disease burden and projection of low back pain in China from 1990 to 2021[J]. Modern Preventive Medicine, 2025 , 52 (13) : 2323 -2327 . DOI: 10.20043/j.cnki.MPM.202503037
正文
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腰痛（low back pain）是全球常见的公共卫生问题，严重影响个人的生活质量和工作能力。根据全球疾病负担（Global Burden of Disease,GBD）研究的数据，腰痛是全球致残的主要原因之一，给个人和社会带来了巨大的经济负担[1]。从1990—2019年，全球腰痛的发病率增加了50%，从149 294 134例/年增加到223 455 641例/年[2]。根据GBD的预测，到2050年，全球预计将有8.43亿人患有腰痛[1]。腰痛的流行病学特征因年龄、性别和地理位置的不同而显著变化。2019年，腰痛病例数最多的国家是中国（4 016万例）、印度（2 963万例）和美国（1 373万例），这三个国家的病例数占全球腰痛病例的37.4%[3]。腰痛的全球发病率在80～84岁年龄段达到峰值，并且女性在全年龄段的发病率均高于男性[3]。目前，针对中国腰痛的长期趋势和未来预测研究相对较少。本研究旨在利用GBD 2021数据库，对1990—2021年中国腰痛的患病率、发病率及伤残调整生命年（disability-adjusted life years,DALY）进行综合分析，并使用贝叶斯年龄-时期-队列（Bayesian age-period-cohort,BAPC）模型对2022—2036年的腰痛发病率进行预测。研究结果将为中国腰痛的流行病学提供新的视角，以期减少腰痛造成的社会和经济负担。
1　资料与方法
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1.1　数据来源
本研究的数据来自更新后的2024年GBD 2021数据库（https://vizhub.healthdata.org/gbd-results/），该数据库涵盖了204个国家、369种疾病和88个风险因素的疾病负担[4]。数据检索策略如下：死亡或损伤原因（腰痛）、指标（DALYs+患病率+发病率）、度量方式（数量+比率）、地点（中国）、年龄（所有年龄+年龄标化，从0～94岁按5年间隔分组）、性别（男性+女性+男女合计）。腰痛的疾病负担指标包括年龄标化患病率（age-standardized prevalence rate,ASPR）、年龄标化发病率（age-standardized incidence rate,ASIR）和年龄标化伤残调整生命年率（age-standardized DALY rate,ASDR），这些指标通过调整各地区人口年龄结构的差异，以确保具有可比性[5-6]。
1.2　统计分析
通过Excel 2024整理1990—2021年的腰痛负担数据，使用R 4.3.1、RStudio以及joinpoint 5.1软件进行统计分析，统计模型采用joinpoint回归模型和BAPC模型。
1.2.1　Joinpoint回归模型
Joinpoint回归模型用于分析1990—2021年中国腰痛的患病率、发病率和DALYs的趋势。计算年度百分比变化（annual percent change,APC）和平均年度百分比变化（average annual percent change,AAPC）。通过蒙特卡罗置换（Monte Carlo permutation）检验评估趋势的统计显著性，显著性水平设定为α=0.05[7]。APC或AAPC大于0表示趋势上升，小于0则表示趋势下降，而P<0.05表示统计上显著。
1.2.2　BAPC模型
BAPC模型用于预测2021年以后的中国腰痛负担。该模型基于贝叶斯推断，可以在考虑年龄、时期和队列效应的同时预测疾病负担的长期趋势。BAPC模型在处理稀疏和异质性数据方面具有很强的鲁棒性，能够提供更为准确的预测。模型构建和推断是在RStudio中使用BAPC包完成的，参数通过马尔可夫链蒙特卡罗（Markov Chain Monte Carlo）方法进行估计。
2　结果
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2.1　1990—2021年中国腰痛的疾病负担
1990—2021年，中国腰痛总病例数从68 281 007例增加到100 093 746例，其中男性占比从38.84%增加到39.11%，女性从61.16%降至60.89%。1990—2021年，新发腰痛病例数从29 843 970例增加到43 374 995例，其中男性占比从39.99%降至39.56%，女性从60.01%增至60.44%。见表1。1990年，中国腰痛的ASPR为6 635.49/10万，2021年下降至5 342.10/10万。ASIR从1990年的2 859.38/10万降至2021年的2 342.46/10万。ASDR从1990年的749.03年/10万降至2021年的603.03年/10万。见表2。
2021年，女性患病和发病的人数峰值均出现在55～59岁，男性患病和发病的人数峰值均出现在50～54岁。女性在所有年龄段的患病率均高于男性。男性在35～44岁的发病率与女性接近，但在其余年龄段的发病率均低于女性。见图1。
Joinpoint回归分析的结果显示，1990—2021年，中国腰痛的ASPR、ASIR和ASDR呈现出快速下降、逐渐下降和缓慢上升的不同阶段。1990—1994年，ASPR、ASIR和ASDR显著下降，分别整体减少了3.62%、3.23%、3.61%，其中女性的下降幅度比男性更为显著。在此之后，1994—2014年，ASPR、ASIR和ASDR的下降趋势有所放缓，2014年以后，分别出现了0.33%、0.28%、0.29%的轻微上升趋势。见表3。
2.2　2022—2036年中国腰痛的发病率预测
基于1990—2021年中国腰痛的发病率数据，使用BAPC模型预测了2022—2036年男性和女性的ASIR趋势。预测结果显示，男性的ASIR将呈上升趋势，而女性的ASIR将下降。到2036年，男性的ASIR预计增加至每10万人1 975.60例，而女性的ASIR预计下降至每10万人2 725.73例。见图2。
3　讨论
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本研究发现，1990—2021年，中国地区腰痛的绝对病例数持续增加，但ASPR、ASIR和ASDR等指标整体呈下降趋势。疾病负担在1990—1994年呈快速下降趋势，在1994—2014年呈缓慢下降趋势，但2015年后出现上升的迹象，这与中国的城市化进程及不健康的生活方式有关。女性腰痛的疾病负担比男性更大，在全年龄段的患病率和发病率均大于男性，这与以往研究结果一致[1-3]。这与社会文化背景、解剖学差异以及怀孕相关的生理变化有关。在亚洲文化背景下，中国女性通常面临家庭和工作的双重负担，这是她们腰痛负担较高的主要原因之一。需要照顾家人的女性患腰痛的风险增加2.78倍，而工作强度高的职场女性的腰痛风险增加4倍[8]。62%～68%的孕妇在怀孕期间会经历腰痛，通常表现为伴随灼烧感的间歇性疼痛，与体重增加、重心前移及脊柱的解剖变化密切相关[9-10]。此外，腰痛女性的残疾率显著高于男性，女性的平均残疾比例为37.3%，而男性为29.2%[11]。
尽管既往的数据表明腰痛对女性造成的负担要大于男性，但根据本研究的模型预测，未来男性腰痛的发病率将上升，而女性的发病率将下降，这可能与我国社会生产模式转型及居民生活习惯转变有关。在GBD数据库中，腰痛有三大相关风险因素：职业工效学、吸烟和身体质量指数（body mass index,BMI）。近年来，职业工效学和吸烟对腰痛的影响有所下降[12]。这是因为我国工业化进程导致过去许多重体力劳动被机器所取代，并且我国年轻群体的吸烟率在逐年下降[13]。然而，高BMI对腰痛的影响却在逐年上升[12]。据调查，在儿童和青少年阶段，中国男性的BMI及腰围普遍高于女性[14]。而且，成年男性的BMI及腰围的逐年增长率也高于女性[15]。因此，日益增长的BMI是男性腰痛的发病率上升的重要原因。
最后，本研究存在一定局限性。GBD对疾病负担的估计主要依赖于预测模型，而非实际的观察数据。因此，在制定公共卫生政策时，应谨慎解读GBD的研究结果。
基金
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  • 四川省中医药管理局重点科研项目(2024zd025)
  • 四川省保健科研项目(川健研2025-501)
  • 成都中医药大学临床医学院研究生科研创新实践项目(2023KCY01)
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参考文献 引证文献
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GBD 2021 Low Back Pain Collaborators. Global, regional,and National burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021[J] . LANCET RHEUMATOLOGY, 2023, 5(6): e316-e329.
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Wang LF, Ye H, Li ZC, et al. Epidemiological trends of low back pain at the global, regional, and National levels[J] . European Spine Journal, 2022, 31(4): 953-962.
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Gu Y, Wang ZM, Shi HW, et al. Global, regional, and National change patterns in the incidence of low back pain from 1990 to 2019 and its predicted level in the next decade[J] . International Journal of Public Health, 2024, 69: 1606299.
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GBD 2021 Risk Factors Collaborators. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021[J] . Lancet, 2024, 403(10440): 2162-2203.
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GBD 2021 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021[J] . Lancet, 2024, 403(10440):2133-2161.
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Fay MP, Feuer EJ. Confidence intervals for directly standardized rates: a method based on the gamma distribution[J] .Medicine Statistics, 1997, 16(7): 791-801.
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Yip Y, Ho SC, Chan S. Socio-psychological stressors as risk factors for low back pain in Chinese middle-aged women[J] . Journal of Advanced Nursing, 2001, 36(3): 409-416.
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Carvalho MECC, Lima LC, de Lira Terceiro CA, et al. Lombalgia na gestac,ão low back pain during pregnancy[J] . Rev Bras Anestesiol,2017, 67(3): 266-270.
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Amayri A, Khalayli N, Haj AD, et al. Low back pain in a sample of Syrian pregnant women: A cross-sectional study[J] . Health Sci Rep,2023, 6(7): e1389.
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Lu YM, Chen CH, Lue YJ. A cross-sectional study of disability and quality of Life in patients with low back pain: Focus on sex and gender[J] . Journal of Back and Musculoskeletal Rehabilitation, 2022,35(1): 177-184.
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吴惠一，袁琴，张洋，等.1990―2019年我国肌肉骨骼疾病负担分析[J] .中华疾病控制杂志，2023，27（6）：655-661.
Wu HY, Yuan Q, Zhang Y, et al. Disease burden of musculoskeletal disorders in China from 1990 to 2019[J] . Chinese Journal of Disease Control & Prevention, 2023, 27(6): 655-661.(In Chinese)
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杜文雯，房红芸，周玮玮，等.1982-2016年中国6-17岁儿童青少年体质指数和腰围变化趋势[J] .卫生研究，2025，54（2）：175-180.
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2025年第52卷第13期
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文章信息
doi: 10.20043/j.cnki.MPM.202503037
  • 接收时间：2025-03-03
  • 首发时间：2026-03-19
  • 出版时间：2025-07-10
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  • 收稿日期：2025-03-03
基金
四川省中医药管理局重点科研项目(2024zd025)
四川省保健科研项目(川健研2025-501)
成都中医药大学临床医学院研究生科研创新实践项目(2023KCY01)
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    成都中医药大学附属医院，四川 成都 610075

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樊效鸿，E-mail:：
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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