The incidence of attention deficit hyperactivity disorder (ADHD) in Chinese pediatric populations has shown a marked upward trajectory in recent years. While traditional Chinese medicine (TCM) compound formulas have demonstrated distinctive advantages in ADHD treatment and related clinical research continues to expand, there remains a notable gap in comprehensive evaluations integrating multiple parameters. Current studies still fall short in conducting multi-dimensional evaluation and optimal regimen screening of TCM compound formulas by integrating indicators such as treatment duration, therapeutic efficacy, and medication frequency.

To identify optimal TCM compound formulas for treating ADHD through multicriteria decision making based on network meta-analysis (NMA) and the entropy-weighted technique for order preference by similarity to an ideal solution (TOPSIS) method.

Comprehensive literature searches were conducted across databases including CNKI, Wanfang Data, VIP, CBM, PubMed, Cochrane Library, Web of Science, and Embase to identify randomized controlled trials (RCTs) investigating TCM compound formulas for ADHD treatment. The search timeframe spanned database inception through December 20, 2024. Two researchers performed study selection and data extraction independently. Assessment of the quality of included studies was performed with the Cochrane risk of bias tool for randomized trials (ROB 2.0), while the certainty of evidence from the NMA was graded using CINeMA. NMA was conducted to derive synthesized surface under the cumulative ranking curve (SUCRA) values for both therapeutic efficacy rates and hyperactivity indices of various TCM compound formulas. Concurrently, weighted averages of intervention duration and administration frequency were calculated using original study sample sizes as weighting coefficients. These parameters were integrated to construct a multicriteria decision matrix. Objective weights for evaluation metrics were determined through entropy weighting, followed by systematic screening of optimal regimens using the TOPSIS method to resolve multi-dimensional trade-offs.

A total of 27 articles were included, and 20 TCM compound regimens were identified through NMA and weighted calculations. The top-three regimens identified by entropy-weighted TOPSIS method were Ningdong Granule, Pediatric Huanglong Granule, and Longmu Anshen Granule. These regimens demonstrated superior advantages in higher clinical efficacy rates, significant reductions in hyperactivity indices, and lower dosing frequency.

The identified protocols, including Ningdong Granule and Pediatric Huanglong Granule, were identified as favorable treatment options due to their balanced benefits in both clinical effectiveness and time efficiency. This outcome may inform clinical decision-making in TCM compound formulas and direct future research on new drug development. Furthermore, the integration of NMA and entropy-weighted TOPSIS method introduces an innovative methodology for constructing and selecting optimized herbal interventions for ADHD.

近年来中国儿童和青少年注意缺陷多动障碍（ADHD）的发病率呈上升趋势，中药复方治疗ADHD优势凸显，且相关临床研究日益增多，然而目前仍缺乏综合干预周期、疗效、用药频次等指标对中药复方进行多维度评价及优势方案筛选的研究。

基于网状Meta分析和熵权逼近理想解排序（TOPSIS）法进行多指标决策，以筛选中药复方治疗ADHD的优势方案。

检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Cochrane Library、Web of Science和Embase数据库，收集中药复方治疗ADHD的随机对照研究，检索时限为建库至2024-12-20。由2名研究者独立进行文献筛选和资料提取，采用Cochrane偏倚风险评估工具（ROB 2.0）评价纳入文献的质量，使用CINeMA对网状Meta分析证据质量进行分级。通过网状Meta分析获得整合后的各中药复方有效率及多动指数累计概率排序曲线下面积（SUCRA）值，同时以每项原始研究的样本量为权重计算各药物的干预周期和用药频次的加权平均值，以此构建用药方案并进行多指标决策分析，最终通过熵权法确定不同指标的权重后进一步运用TOPSIS法对优势用药方案进行筛选。

共纳入27篇文献，经网状Meta分析整合及加权计算后获得20种中药复方用药方案。熵权TOPSIS法最终筛选结果排名前三的为宁动颗粒、小儿黄龙颗粒、龙牡安神颗粒方案，其主要优势在于有效率较高、多动指数降低较明显且用药频次较少。

本研究筛选出的宁动颗粒、小儿黄龙颗粒等方案兼具临床疗效佳和时间成本低的双重优势，对临床实践过程中药复方的选择和新药的研发方向具有一定的参考价值。基于网状Meta分析和熵权TOPSIS法的多指标决策分析框架开拓了中药治疗ADHD优势方案构建和筛选的新思路。