Uptake of nutritional supplementation during pulmonary rehabilitation (PR) for people with chronic obstructive pulmonary disease (COPD) has been limited by an absence of rigorous evidence-based studies supporting use. The objective was to report and summarise the current evidence supporting the use of nutritional supplementation to improve outcomes during PR in stable COPD patients. A systematic search was conducted up to 7 August 2019 (registration number CRD42018089142). The preferred reporting items for systematic reviews and meta-analyses guidelines were used. Six databases were included: Medical Literature Analysis and Retrieval System Online or MEDLARS Online, Allied and Complementary Medicine Database, the Cochrane Database of Systematic Reviews, Excerpta Medica dataBASE, Cumulative Index of Nursing and Allied Health Literature and Web of Science. This systematic search generated 580 initial matches, of which 22 studies (917 COPD participants) met the pre-specified criteria and were included. Sixteen of 19 studies that used nutritional supplements in addition to PR did not show additional benefit compared to PR alone when measuring exercise capacity. Nutritional supplements significantly increased body weight in 7 of 11 studies. Body mass index increased significantly in two of six studies. Handgrip strength did not improve, while quadriceps muscle strength significantly improved in 3 of 11 studies. Four of eight studies showed a significant improvement in inspiratory muscle function. Only 2 of 14 studies demonstrated a significant improvement in quality of life with supplementation in addition to PR. There remains insufficient evidence on the effect of nutritional supplementation on improving outcomes during PR in patients with COPD due to heterogeneity in supplements, outcome measures and PR programmes. Therefore, controversy remains and further research is needed.

由于缺乏严格的循证医学支持使用的研究，慢性阻塞性肺疾病（COPD）患者在肺康复（PR）过程中对营养补充剂的摄取受到限制。目的是报告和总结目前的证据，这些证据支持在稳定的COPD患者PR期间使用营养补充剂改善预后。截至2019年8月7日，进行了系统的检索（注册号CRD42018089142）。使用了系统评价和荟萃分析指南的首选报告项目。包括六个数据库：在线医学文献分析和检索系统或MEDLARS，专职和补充医学数据库，Cochrane系统评价数据库，Excerpta Medica数据库，护理及相关健康文献和科学网累积指数。这项系统的搜索产生了580个初始匹配，其中22个研究（917个COPD参与者）符合预定标准。在测量运动能力时，与PR相比，在PR之外还使用营养补充剂的19项研究中，有16项没有显示额外的益处。营养补充剂在11项研究中的7项中显着增加了体重。在六项研究中的两项中，体重指数显着增加。11个研究中的3个研究中，握力没有改善，而股四头肌的肌力却明显改善。八项研究中有四项显示吸气肌肉功能有明显改善。在14项研究中，只有2项显示，除了PR外，通过补充生活质量也得到了显着改善。由于补充剂，结局指标和PR方案的异质性，尚无足够的证据表明营养补充剂可改善COPD患者PR期间的结局。因此，争议仍然存在，需要进一步的研究。