Background: To evaluate the objective response rate (ORR) and disease control rate of 3 Chinese herbal medicines (Compound Banmao Capsule, Huaier Granule, and Jinlong Capsule) combined with transarterial chemoembolization (TACE) for primary liver cancer using Bayesian network meta-analysis. Methods: We systematically searched randomized controlled trials (RCTs) across the Cochrane Library, Embase, PubMed, Web of Science, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang databases from their inception to January 10, 2025. Two researchers independently screened the literature, extracted data, and assessed study quality using predefined inclusion and exclusion criteria. A Bayesian network meta-analysis was performed using RStudio to synthesize and hierarchically rank interventions by effect size in the included RCTs. This review was registered with PROSPERO (CRD420251019361). Results: Thirty-one RCTs involving 2604 patients with primary liver cancer were included. The network meta-analysis showed that, compared with TACE alone: Compound Banmao Capsule ranked highest for ORR (OR = 1.50, 95% CI: 1.08, 2.08), followed by Huaier Granule (OR = 1.47, 95% CI: 1.05, 2.05) and Jinlong Capsule (OR = 1.30, 95% CI: 1.02, 1.65). For disease control rate, the ranking was Compound Banmao Capsule (OR = 1.21, 95% CI: 0.76, 1.93), Jinlong Capsule (OR = 1.17, 95% CI: 0.85, 1.59), and Huaier Granule (OR = 1.12, 95% CI: 0.66, 1.91). Conclusion: For ORR, the combination of the 3 Chinese herbal medicines with TACE showed superior efficacy to TACE monotherapy, with Compound Banmao Capsule demonstrating the greatest therapeutic potential among the interventions evaluated.
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