Abstract: Background　With the increasingly recognized critical role of nutritional rehabilitation in the treatment of anorexia nervosa, relevant clinical guidelines domestically and internationally have been continuously developed and updated, providing important references for clinical practice. However, their quality varies, necessitating a systematic review to promote scientific and standardized clinical practice. Objective　To systematically review guidelines on nutritional rehabilitation for patients with anorexia nervosa, analyze the similarities and differences in recommendations across guidelines, and provide evidence-based references for clinical decision-making. Methods　Systematic searches were conducted in PubMed, Embase, CINAHL, Web of Science, Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure, Chinese Biomedical Literature Database,VIP Database, the International Guideline Collaboration website, the National Institute for Health and Care Excellence website,the National Guideline Clearinghouse,the Registered Nurses' Association of Ontario website, the Scottish Intercollegiate Guidelines Network website, the Chinese Medical Pulse guideline website, and related professional association websites for guidelines on nutritional rehabilitation for patients with anorexia nervosa. The search timeframe was from database inception to May 31, 2025. Four researchers used the Appraisal of Guidelines for Research & Evaluation Instrument Ⅱ to assess the quality of the guidelines and summarized and analyzed their recommendations. Results　Fourteen guidelines were ultimately included, with publication or update dates ranging from 2005 to 2023. These included five from the United States, three from the United Kingdom, two from Scotland, and one each from Germany, France, Australia, and China. Eleven guidelines received Grade A recommendations, and three received Grade B. The relevant recommendations focused on general principles of nutritional management, nutritional assessment and staging, nutritional rehabilitation plans (target weight gain, caloric intake prescription, micronutrients, nutritional rehabilitation pathways), complication management, and psychological intervention. Conclusion　The methodological quality of guidelines on nutritional rehabilitation for patients with anorexia nervosa is relatively high. However, inconsistencies in recommendations exist among different guidelines. It is recommended that multidisciplinary teams in clinical practice carefully integrate existing evidence to develop individualized nutritional rehabilitation plans for patients to promote their comprehensive recovery.

Key words: Anorexia nervosa, Nutritional rehabilitation, Guidelines, Systematic review, Evidence-based medicine

摘要： 背景　随着神经性厌食营养重建在治疗中的关键作用日益明确，国内外相关临床指南持续完善更新，为临床实践提供了重要参考；但现有指南质量参差不齐，有必要开展系统评价，推动临床实践更加科学化、规范化。目的　对神经性厌食患者营养重建相关指南开展系统评价，分析各指南推荐意见的异同，为临床提供循证决策依据。方法　系统检索PubMed、Embase、CINAHL、Web of Science、万方数据知识服务平台、中国知网、中国生物医学文献数据库、维普网、国际指南协作网、英国国家卫生与临床优化研究所网站、美国国立指南文库、加拿大安大略注册护士协会网站、苏格兰校际指南网、中国医脉通指南网及相关专业协会网站中神经性厌食患者营养重建的相关指南，检索时限均为建库至2025-05-31。由4名研究者采用临床指南研究与评价工具Ⅱ对纳入指南进行质量评价，并汇总分析各指南的推荐意见。结果　最终纳入14篇指南，制订或更新时间为2005—2023年，其中美国5篇、英国3篇、苏格兰2篇、德国1篇、法国1篇、澳大利亚1篇、中国1篇。A级推荐指南11篇，B级推荐指南3篇。相关推荐意见围绕营养管理总原则、营养评估与分级、营养重建计划（体质量增长目标值、热量摄入处方、微量营养素、营养康复途径）、并发症管理及心理干预。结论　神经性厌食患者营养重建相关指南整体方法学质量较高，但各指南推荐意见仍存在一定不一致。建议多学科团队在临床实践中审慎整合现有循证证据，为患者制订个体化营养重建方案，助力患者全面康复。

关键词: 神经性厌食, 营养重建, 指南, 系统评价, 循证医学