Traditional Chinese Medicine (TCM) has been applied at all stages of hepatocellular carcinoma (HCC) management, including prior to tumor development. Nonetheless, its effectiveness in lowering the risk of HCC among patients with hepatitis B-related cirrhosis remains uncertain. This study aims to systematically evaluate this issue. Relevant studies were retrieved from PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, SinoMed, VIP, and WanFang databases. Relative risks (RRs) with 95% confidence intervals (CIs) were calculated, and heterogeneity across studies was assessed. The risk of bias was evaluated using the Cochrane Collaboration’s tool. A total of 10 studies involving 2,702 patients were included. The findings indicated that TCM combined with conventional therapy significantly lowered HCC incidence in patients with post-hepatitis B cirrhosis at 1-, 3-, and 5-year follow-ups. The preventive benefit was observed primarily in patients with compensated cirrhosis, whereas it was not significant in decompensated cirrhosis. Additionally, TCM was associated with improved liver function and better virological outcomes. Integration of TCM with standard therapy shows potential in reducing HCC risk among patients with hepatitis B-related cirrhosis, likely through improvements in liver function and viral response. However, further high-quality randomized controlled trials are needed to confirm these effects and provide more robust evidence.
