Abstract： Objective： To observe and compare the differences in the clinical effect and the incidences of adverse reactions of transcatheter arterial chemoembolization(TACE) combined with elemene injection and cinobufagin injection respectively for middle and advanced primary hepatic carcinoma. Methods：A total of 104 cases of patients with middle and advanced primary hepatic carcinoma who were treated in the oncology department from August 2018 to January 2020 were included as the study objects，and were randomly divided into two groups according to different treatment regimens，52 cases in each group. Both groups were treated with TACE once； the cinobufagin injection group was given intravenous infusion with 500 mL of 5% glucose injection and 10 mL of cinobufagin injection once a day；the elemene injection group was given intravenous infusion with elemene injection of 0.4 g each time and once a day. Both groups were treated for two courses，15 days of continuous treatment with a rest of 15 days being one course. The clinical effect，the changes in the indexes of liver function including alanine amino transferase(ALT)，aspartate transaminase(AST) and total bilirubin(TBil)，the scores of alpha-fetoprotein(AFP) and Karnofsky(KPS) and tumor volumes as well as the difference in the incidences of adverse reactions between the two groups were observed and compared. Results：The total clinical effective rate was 88.46% in the elemene injection group and 71.15% in the cinobufagin injection group， the difference being significant(P＜0.05). After treatment，the levels of ALT，AST and TBil in serum in the two groups were significantly decreased when compared with those before treatment， differences being significant(P＜0.05). There was no significant difference being found in the comparison of the levels of ALT，AST and TBil in serum between the two groups(P＞0.05). After treatment，the decrease of AFP，tumor volume and the increase of KPS scores in the elemene injection group were significantly more than those in the cinobufagin injection group， differences being significant(P＜0.01). During treatment， there was no significant difference being found in the comparison of the total incidences of adverse reactions between the two groups(P＞0.05). The adverse reactions in the cinobufagin injection group were mainly nausea and vomiting，with higher incidence than that in the elemene injection group，the difference being significant(P＜0.05). The adverse reactions in the elemene injection group were mainly pain at the injection site，with higher incidence than that in the cinobufagin injection group，the difference being significant (P＜0.05). Conclusion： The therapy of elemene injection combined with TACE for middle and advanced primary hepatic carcinoma has better clinical effect than that of cinobufagin injection，but the occurrence of adverse reactions should still be paid attention to during the treatment with the two Chinese herbal medicines.