Five-Elements Music Therapy Clinical Outcomes Review

Research has consistently indicated that Five-Elements Music Therapy from Traditional Chinese Medicine can help alleviate anxiety and depression. This therapy draws on Five Element theory to map musical elements onto emotional processes, facilitating whole-system regulation. When delivered alongside standard care, it is associated with reduced stress, improved emotional symptoms, and increased patient engagement, positioning it within integrative care models that address psychosocial and physiological aspects of illness. The following studies have shown promising outcomes across oncology, perioperative, and chronic disease settings, suggesting a pattern of psychosocial regulation; however, the results remain underspecified.

A group of people sitting on top of a wooden box. Photo by Alvaro Palacios on Unsplash.

The First study conducted a retrospective comparative analysis of 78 patients with diffuse large B-cell lymphoma who received standard care plus Five-Element Music Therapy and mindfulness meditation. Those who received the combined practice/therapy showed reduced fatigue, anxiety, and depression, as well as better sleep, greater engagement with treatment, and improved overall quality of life, with evidence suggesting multiple interconnected pathways in which intervention at one dimension creates beneficial changes that cascade across multiple physiological domains.

The second study conducted a hospital-based comparative analysis involving 460 patients with lung cancer who received Five-Element Music therapy alongside conventional nursing care, compared to conventional nursing care alone. They showed a significantly greater reduction in cancer-related fatigue, anxiety/depression levels, and improved behavioral, physical, emotional, and cognitive status. Logistic regression indicates that improvements in mood may be associated with increased treatment adherence, supporting this therapy as an effective adjunct for managing symptoms and psychosocial well-being.

The Third study employed a retrospective comparative analysis of patients undergoing surgery and receiving Five-Element Music Therapy alongside routine traditional nursing care. For preoperative patients, they found that, compared to routine care alone, the patients receiving Five-Element Music Therapy showed significant improvements in quality of sleep and a reduction in pain and anxiety. However, subsequent findings indicate short-term stabilization, suggesting that the effects were not sustained beyond the immediate perioperative period.The fourth study was a retrospective study of 156 hospitalized patients with a diagnosis of decompensated liver cirrhosis. They compared the effects of those receiving Five Element Music Therapy in combination with Traditional Chinese Medicine rehabilitation care against those receiving rehabilitation alone. The findings indicate improvements in anxiety, depression levels, and sleep quality, and various nutritional indicators, while no significant between-group differences were observed in liver function outcomes.

Tags: Five-Elements Music Therapy, integrative oncology, mind–body intervention, psychosocial symptom management, Traditional Chinese Medicine (TCM)

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Referenced Research Publications

Noise & Health

2025, November 1

DOI: 10.4103/nah.nah_145_25

Abstract

Background

Patients with diffuse large B-cell lymphoma (DLBCL) frequently experience cancer-related fatigue (CRF), anxiety and depression during chemotherapy, significantly impairing their quality of life. This study evaluates the efficacy of the five-element music therapy combined with mindfulness meditation in alleviating CRF and psychological distress amongst DLBCL patients who are undergoing chemotherapy.

Methods

We conducted a retrospective study on 78 DLBCL patients who were treated at the First Affiliated Hospital of Soochow University (June 2022–December 2023). The patients were divided as follows: (1) conventional care group (n = 39) and (2) conventional care + combined five-element music therapy and mindfulness meditation group (combined group, n = 39). The assessed outcomes included the following: Cancer Fatigue Scale, Pittsburgh Sleep Quality Index (PSQI), the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), the Hamilton Depression (HAMD) and Hamilton Anxiety (HAMA) scales, treatment compliance and nursing satisfaction scores.

Results

Compared with the conventional care group, the combined group had lower scores in physical fatigue, emotional fatigue and cognitive fatigue (all P < 0.001); lower scores in HAMD, HAMA and PSQI (all P < 0.001); longer sleep duration (P < 0.001); better compliance (P = 0.023); higher satisfaction (P = 0.042) and a higher score in EORTC QLQ-C30 (all P < 0.001).

Conclusion

The combination of the five-element music therapy with mindfulness meditation reduces CRF, anxiety and depression amongst DLBCL chemotherapy patients whilst enhancing treatment compliance, sleep quality and overall quality of life. This combined non-pharmacological approach demonstrates promise as an adjunctive therapy in oncology care.

Reference

Chen, T., Niu, H., & Wang, Y. (2025). Efficacy of the Five-Element Music Therapy Combined with Mindfulness Meditation on the Fatigue, Anxiety and Depression of Diffuse Large B-Cell Lymphoma Patients Who Are Undergoing Chemotherapy. Noise & health, 27(129), 863–871. https://doi.org/10.4103/nah.nah_145_25

Noise & Health

2025, November 1

DOI: 10.4103/nah.nah_153_25

Abstract

Objective

This research explored the potential benefits of five-element music in cancer-related fatigue (CRF) and mood disturbances among patients with lung cancer.

Methods

This study included 460 hospitalised patients with lung cancer from July 2023 to February 2024. The participants were divided into two arms as follows: 217 received five-element music therapy and conventional nursing care (combined group), whilst 243 were assigned to conventional nursing care (routine group). Outcomes such as adverse reactions, Piper Fatigue Rating Scale (PFS-R) score and psychological status (Self-rating Anxiety Scale [SAS] and Self-rating Depression Scale [SDS] scores) were assessed before and after the care. The logistic regression model was used to explore the influence of five-element music on the above indicators.

Results

Post-care data revealed declines in PFS-R scale scores for both groups, with the combined group exhibiting superior outcomes in cognition, behaviour, body and emotion (all P < 0.001). Psychological metrics (SAS/SDS) similarly favoured the combined group (all P < 0.001). The combined group demonstrated a significantly higher medication compliance rate than the routine group (92.63% vs. 81.48%, P < 0.001), underscoring the therapeutic advantage of the proposed approach. The results of logistic regression showed that significant associations were found between medication compliance and two key factors: anxiety scores (SAS, odds ratio [OR]: 1.055, 95% confidence interval [CI]: 1.013–1.100) and depression scores (SDS, OR: 1.246, 95% CI: 1.178–1.318).

Conclusion

The application of five-element music therapy demonstrates potential benefits for patients with lung cancer, including alleviating CRF, mitigating negative emotions and improving medication compliance.

Reference

Liu, H., Xia, G., Zhang, Q., Liang, S., & Mo, M. (2025). Effects of Five-Element Music on Cancer-Related Fatigue and Negative Emotion in Patients with Lung Cancer. Noise & health, 27(129), 811–818. https://doi.org/10.4103/nah.nah_153_25

Noise & Health

2024, July 1

DOI: 10.4103/nah.nah_77_24

Abstract

Objective

This study aimed to explore the effect of five-element music therapy on sleep status during perioperative period and psychological regulation in patients undergoing orthopedic surgery.

Methods

The medical records of patients who underwent orthopedic surgery from March 2021 to December 2023 in the Gansu Provincial Hospital of Traditional Chinese Medicine were retrospectively analyzed. Patients were divided into two groups in accordance with the nursing time period. The control group (88 patients) received routine nursing, and the observation group (78 patients) received five-element music management in the perioperative period based on routine nursing. The management time was from admission to one week after surgery, with 30 min/times, TID. The sleep, physical signs, pain condition, and anxiety status of the two groups were compared on admission, before surgery, and one week after surgery.

Results

On admission, no significant difference in the scores of the Pittsburgh Sleep Quality Index (PSQI), the pain rating index (PRI), and the Self-Rating Anxiety Scale (SAS) was found between the two groups (P > 0.05). Before and one week after surgery, the PSQI, PRI, and SAS scores of the observation group were significantly lower than those of the control group (P < 0.001). No significant difference was found in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) between the two groups on admission and one week after surgery (P > 0.05). Before surgery, the observation group had significantly lower indices of SBP, DBP, and HR than the control group (P < 0.05).

Conclusion

Five-element music stimulation in the perioperative period can improve the pain and anxiety of patients undergoing orthopedic surgery and enhance their sleep status.

Reference

Ren, Z., & Xue, Y. (2024). Effects of Five-Element Music Stimulation in Perioperative Period on Sleep Status and Psychological Regulation in Patients Undergoing Orthopedic Surgery. Noise & health, 26(122), 403–409. https://doi.org/10.4103/nah.nah_77_24

Noise & Health

2026, January 1

DOI: 10.4103/nah.nah_169_25

Abstract

Objective

This study aimed to investigate the effects of five-element music therapy combined with Traditional Chinese Medicine (TCM) comprehensive rehabilitation on liver function, nutritional status, sleep quality and psychological state in hospitalised patients with decompensated liver cirrhosis.

Methods

A retrospective analysis was conducted on 156 patients hospitalised for decompensated liver cirrhosis from June 2022 to March 2024. The patients were divided into two groups as follows: TCM comprehensive rehabilitation (76 cases) and five-element music therapy combined with TCM comprehensive rehabilitation (80 cases). Changes in psychological state (Self-rating Anxiety Scale [SAS] and Self-rating Depression Scale [SDS]), liver function (alanine aminotransferase [ALT], aspartate aminotransferase [AST], total bilirubin [TBIL], direct bilirubin [DBIL] and albumin [ALB]), nutritional status (haemoglobin, prealbumin [PA], total protein, Nutritional Risk Screening 2002 and Simplified Nutritional Appetite Questionnaire [SNAQ]) and sleep quality (Pittsburgh Sleep Quality Index [PSQI]) were compared before and after the nursing approach was implemented.

Results

Both groups showed significant improvements post-nursing approach in SAS, SDS, liver function, nutritional status and sleep quality (P < 0.05). The five-element music therapy group exhibited significant reductions in SAS, SDS and PSQI scores and better improvements in PA and SNAQ scores than the TCM comprehensive rehabilitation group (P < 0.05). Although the liver function indicators (ALT, AST, TBIL, DBIL and ALB) improved in both groups, no statistically significant differences were observed between groups (P > 0.05).

Conclusion

Five-element music therapy combined with TCM comprehensive rehabilitation significantly improves psychological state, nutritional status and sleep quality in hospitalised patients with decompensated liver cirrhosis. This integrative care model is worth promoting in clinical practice.

Reference

Jiang, L., Zhang, L., Chen, S., & Wang, Y. (2026). Effects of Five-Element Music Therapy Combined with Traditional Chinese Medicine Rehabilitation on Clinical Outcomes in Decompensated Liver Cirrhosis. Noise & health, 28(130), 72–81. https://doi.org/10.4103/nah.nah_169_25

Frontiers in Psychology

2025, September 28

DOI: 10.3389/fpsyg.2025.1625325

Abstract

Background

The efficacy of Traditional Chinese Medicine (TCM) Five Elements Music in intervening anxiety and depression has been extensively validated by trials. This study employed three different instruments to perform TCM Five Elements Music interventions on medical students’ anxiety and depression, aiming to evaluate the differences in therapeutic effects and provide empirical evidence for optimizing treatment protocols.

Methods

A total of 148 medical students screened via the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were randomly divided into an Erhu group, Guzheng group, Bamboo flute group, and a Control group (37 participants each). The three intervention groups listened to TCM Five Elements Music for 15 min daily over 2 weeks, while the Control group received no intervention. Pre- and post-intervention assessments were conducted using the SAS and SDS.

Results

Except for the Control group, all three intervention groups showed significantly lower SDS and SAS scores post-intervention compared to pre-intervention (p < 0.01). Statistically significant differences in SDS and SAS scores were observed among the three intervention groups post-intervention (p < 0.01), with the Guzheng group demonstrating the most pronounced intervention effect.

Conclusion

TCM Five Elements Music effectively alleviates anxiety and depression in medical students. The therapeutic effects vary significantly across different instruments, with the Guzheng yielding the most remarkable outcomes.

Reference

Lyu, P., Li, X., & Yao, X. (2025). An empirical study on the intervention of traditional Chinese medicine five-element music in alleviating anxiety and depression among medical students: differences in effectiveness among three different musical instruments. Frontiers in psychology, 16, 1625325. https://doi.org/10.3389/fpsyg.2025.1625325

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Five-Elements Music Therapy Clinical Outcomes Review

Research Glossary

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