Objective?To explore the application value of trans arterial chemoembolization (TACE) combined with dialectical treatment of traditional Chinese medicine in patients with middle-advanced primary liver cancer (PLC) with liver excessive and spleen deficiency type. Methods?From February 2018 to January 2021, 80 patients with middle-advanced PLC with liver excessive and spleen deficiency type in the First Hospital of Hunan University of Chinese Medicine were randomly divided into control group and observation group,with 40 cases in each group. The control group received TACE treatment, and the observation group received TACE+ Fupi Tiaogan decoction treatment before and after operation. 4 weeks after the operation, the efficacy of solid tumors and liver function indexes [serum albumin (ALB), glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), total bilirubin (TBIL)], Karnofsky performance status (KPS) score, BFS score and side effects of the two groups were compared between two groups. Results?4 weeks after operation, the total effective rate of solid tumors in the observation group were higher than that in the control group (P＜0.05); the ALB level and KPS and BFS scores of the observation group were higher than those of the control group, and the levels of GOT, GPT and TBIL were lower than those of the control group (P ＜ 0.05); the incidence of side effects of grade Ⅲ and above in the observation group was lower than that of the control group (P ＜ 0.05). Conclusion?TACE combined with traditional Chinese medicine dialectical treatment has ideal curative effect for patients with middle-advanced PLC with liver excessive and spleen deficiency type, which can significantly improve their prognostic quality of life and play a role in attenuating and protecting the liver.