Traditional Chinese health exercises, rooted in mindfulness-based aerobic therapy, encompass guided movements such as Tai Chi, Ba Duan Jin, Liu Zi Jue, Wu Qin Xi, Yi Jin Jing, and others. These exercises harmonize Yin and Yang and regulate the flow of Qi through coordinated breathing and physical movements (Li et al., 2022). Based on the principles of TCM, these exercises emphasize the integration of mind, Qi, body, and spirit, combining martial arts, guided movements, and breathing techniques. By regulating the body’s Qi and blood, unblocking meridians, nourishing organs, and balancing Yin and Yang, they achieve the goal of nurturing health and well-being (Yang et al., 2020).

Tai Chi is a traditional martial art form that not only includes martial arts techniques and strength training but also emphasizes a health-preserving philosophy integrated with TCM (Zhao et al., 2021). Ba Duan Jin is one of the traditional health exercises, consisting of eight different movements designed for fitness. Yi Jin Jing is an exercise method primarily aimed at strengthening the body and muscles. Its main characteristic is the combination of movement and stillness, with internal stillness used to calm the mind and regulate breathing, while external movement is used to strengthen the muscles and bones. Wuqinxi is a traditional Chinese fitness method invented by the famous doctor Hua Tuo in the late Eastern Han Dynasty, based on the movement patterns of five animals: tiger, deer, bear, monkey, and bird (or crane, according to some versions). It is officially recorded in the “Biography of Hua Tuo” in the “Book of the Later Han.”

Zhang Jingyi (Zhang et al., 2021) and others conducted a meta-analysis on the intervention effects of TCM health-preserving exercises such as Tai Chi, Baduanjin, Yijinjing, and Wuqinxi Qigong on improving negative psychological conditions such as anxiety and depression among college students. The study found that Tai Chi, Baduanjin, Yijinjing, and Wuqinxi can effectively alleviate depressive and anxious symptoms among college students, with Baduanjin and Yijinjing showing superior intervention effects compared to Tai Chi.

Du et al. (2022) conducted a Meta-analysis on the effect of Tai Chi therapy on improving negative psychological symptoms such as anxiety and depression in college students, as well as the optimal intervention dosage. They found that Tai Chi can significantly reduce symptoms of depression and anxiety in college students, with an intervention period of more than 12 weeks and a frequency of three times a week being the most effective. Chen et al. (2015) compared the effects of Baduanjin intervention and relaxation training on college students and found that individuals in the Baduanjin intervention group showed significant improvements in depression scores compared to before the intervention, while there was no significant change in the assessment results before and after the intervention in the control group.

Yu et al. (2021) implemented an intervention program involving sequential practice of 14-form Tai Chi, 12-form health-preserving exercise, Baduanjin, and Wuqinxi among college students with mild depression. Compared to a control group without any intervention, the study showed significant reductions in SDS (Self-Rating Depression Scale), SAS (Self-Rating Anxiety Scale), and PSQI (Pittsburgh Sleep Quality Index) total scores (p < 0.05), indicating that TCM health-preserving exercises can improve depressive symptoms and sleep quality among college students. Gong (2024), through analyzing exercise prescriptions for depression among college students, pointed out that traditional exercises such as Tai Chi have satisfactory effects on improving depression and depressive states among college students. Research has found that Baduanjin can effectively relax the limbs, muscles, mind, and spirit of college students with depression, exhibiting emotional and psychological regulatory effects that can alleviate or even eliminate exercise barriers, thereby enhancing their physical functions and quality of life. Tai Chi can regulate both physiological and psychological aspects, ultimately achieving the goal of treating depression (Gan and Zhong, 2023).

Yu et al. (2019) conducted a META analysis comparing Tai Chi intervention with conventional aerobic exercise intervention among college students with depressive tendencies or depression. The study found that practicing Tai Chi can effectively improve depression among college students, and compared to conventional aerobic exercise with a single format, college students showed longer duration and better persistence in Tai Chi training. Tan and Tan (2020) applied health qigong Baduanjin to intervene in college students with mild to moderate depression, resulting in reduced SDS scores, heart rate, and blood pressure, as well as decreased sensitivity of norepinephrine (NE) and 5-hydroxytryptamine (5-HT) receptors, thereby improving depression levels among college students. Zhang et al. (2023) randomly divided college students with anxiety and depression into an experimental group and a control group. The experimental group underwent a 5-week intervention using Tai Chi Eight Methods and Five Supplements, while the control group did not engage in any exercise intervention. The study found that the SAS and SDS scores of the experimental group were significantly lower than those of the control group (p < 0.01). Through RS-fMRI scanning, the fALFF values in the right middle frontal gyrus, orbital part (Frontal_Mid_Orb_R) of the experimental group were significantly higher (p < 0.05), while those in the left middle frontal gyrus (Frontal_Mid_L) were significantly lower (p = 0.001, p < 0.05) compared to the control group. This suggests that Tai Chi Eight Methods and Five Supplements may alleviate anxiety and depression among college students by regulating the activity of Frontal_Mid_L and Frontal_Mid_Orb_R.

As mentioned above, traditional Chinese medicine health preservation exercises constitute a broad conceptual category, encompassing Tai Chi, Baduanjin, Wuqinxi, etc. To clearly compare the differences among these experiments, particularly in terms of key information such as the number of participants, gender, age, experimental grouping, intervention frequency, and intervention duration, we have created Table 1 to provide a detailed statistical overview of the relevant experiments.

In summary, in terms of intervention forms, a few researchers have adopted multiple TCM health-preserving exercises for intervention, while more researchers have used only one type of TCM health-preserving exercise. The control groups in the above experiments also vary, with some control groups receiving no intervention at all, while others are required to engage in certain exercise training. The experimental results suggest that TCM health-preserving exercises have a certain positive effect and relatively good intervention outcome on intervening in depression among college students.

The concept of music as a means of health preservation and treatment can be traced back to over two thousand years ago. In traditional Chinese characters, the homology of the characters yue (樂, music), yao (藥, medicine), and liao (療, treatment) serves as indirect evidence of the inherent connection between music, medication, and therapeutic practices. Similar to pharmacological treatments, music also possesses the capability to regulate and heal the human body (Li and Wang, 2021). The Records of the Grand Historian (Shi Ji) in the section of Music Book (Yue Shu) records, “Music is able to stimulate the flow of blood, circulate the spirit, and harmonize the mind.” References to the Five-Element Music Therapy can be found in the Yellow Emperor’s Inner Classic (Huang Di Nei Jing), a text dating back over 2,000 years, which advocates the ideas of “Five Tones Healing Diseases,” “The Correspondence of Five Tones,” and “All illnesses originate from the imbalance of Qi (vital energy), and cease with the sound.” This classic also describes “listening to music” as a supreme level of preventive medicine, emphasizing the concept of “superior doctors preventing disease” (Zhao et al., 2022; Huang et al., 2023).

The Yellow Emperor’s Inner Classic associates the five tones with the five elements, five internal organs, five colors, and five emotions. As recorded in Spiritual Pivot – The Invading Guest (Ling Shu – Xie Ke), “The liver belongs to wood, its corresponding tone is jue (horn), and its associated emotion is anger; the heart belongs to fire, its corresponding tone is zhi (scale), and its associated emotion is joy; the spleen belongs to earth, its corresponding tone is gong (palace), and its associated emotion is thought; the lung belongs to metal, its corresponding tone is shang (commercial), and its associated emotion is sorrow; the kidney belongs to water, its corresponding tone is yu (water-drop), and its associated emotion is fear” (Zhang and Liao, 2020). Based on the characteristics of the five internal organs, it is inferred that the five tones of gong, shang, jue, zhi, and yu correspond to the physiological and pathological conditions of the spleen, lung, liver, heart, and kidney, respectively. This forms foundation of the traditional Chinese medicine’s Five-Element Music Therapy, which aims to regulate the “five emotions” by exerting specific effects on the “five internal organs,” thereby achieving therapeutic objectives (Yuan et al., 2021; Cao, 2022). Moreover, the Qing Dynasty physician Wu Shiji’s “A Collection of Medical Prescriptions” (Li Liao Pian Wen) also mentions, “For illnesses arising from the seven emotions, viewing flowers can relieve boredom, and listening to music can dispel sorrow, sometimes even more effectively than taking medication.”

Animal experiments have demonstrated that Five-Element Music can elevate the levels of serotonin (5-HT) in the serum of depressed mice, reduce the content of monoamine oxidase (MAO) in the hippocampus and malondialdehyde (MDA) in the liver, thereby improving depressive behaviors (Cheng et al., 2015). Clinical studies conducted by Chen (2018) have found that Five-Element Music Therapy can alleviate depressive symptoms by possibly reducing the levels of interleukin-1β (IL-1β), interleukin-2 (IL-2), and interleukin-6 (IL-6) in the peripheral blood of depressed patients, thus improving their immune function. Research by Bradt et al. (2021) suggests that musical interventions may alleviate anxiety, depression, and other psychological symptoms among cancer patients. Wang et al. (2020) observed that among medical students with depressive emotions, those who received musical interventions scored significantly lower on SDS (Self-Rating Depression Scale) and SCL-90 depression subscales compared to the non-intervention group (p < 0.05). Chen et al. (2015) conducted a study on nursing students in Taiwan suffering from depression, administering Five-Element Music Therapy. They discovered that after the intervention, the participants’ scores on the Beck Depression Inventory (BDI) and saliva cortisol levels significantly decreased. When compared to a control group without any intervention, the BDI scores of the intervention group were significantly lower (p < 0.05) (Chen et al., 2015).

Yao et al. (2024) conducted an intervention experiment on some university medical students suffering from depression. They divided the participants into four groups: a comprehensive group (where subjects received interventions of both Five-Element Music and Baduanjin), a Five-Element Music intervention group, a Baduanjin intervention group, and a control group. The experiment demonstrated that the comprehensive intervention group had a more significant effect on depression than using Five-Element Music or Baduanjin alone. Bin et al. (2014) used Five-Element Music to intervene with 50 depressed college students, where they listened to music twice a week for 30 min each time, over a period of 6 weeks. The experiment employed the Self-rating Depression Scale (SDS) and the Symptom Checklist-90 (SCL-90) for assessment, proving that traditional Chinese Five-Element Music has a positive impact on improving depressive moods among college students. Xiaolin et al. (2012) conducted an intervention experiment on 60 depressed college students, dividing them into a Five-Element Music group (30 people) and a control group (30 people). The results showed that the total scores of SCL-90 and UPI in the Five-Element Music group were significantly lower than those in the control group, with a significant difference (p < 0.01). The scores for obsession, interpersonal relationship, depression, anxiety, paranoia, and psychoticism factors in the SCL-90 of the Five-Element Music group significantly decreased compared to before the treatment (p < 0.01) (Table 2).

Acupuncture is the general term for Chinese medical needling and moxibustion techniques. Needling involves inserting specially made metal needles into specific accupoints in the patient’s body, and using techniques such as twisting and lifting to achieve the purpose of treating diseases. Moxibustion involves burning mugwort wool and applying it to the skin surface at accupoints, utilizing thermal stimulation to treat diseases.

Acupuncture therapy for depression has become a green therapy accepted and advocated by contemporary mainstream medicine due to its remarkable efficacy in regulating the spirit, nourishing the mind, soothing emotions, and alleviating stress (Li et al., 2023). “Suwen: Six Elements and Great Treatise on the Right Discipline” suggests that acupuncture can be used to warm, unblock, and drain qi stagnation caused by depression.

Meta-analyses have shown that the effectiveness of acupuncture in treating depression is comparable to that of antidepressant medications, with fewer adverse reactions (Zhang et al., 2010). Cai et al. (2021) randomly divided 60 depressed university students into an acupuncture group (n = 30) and a medication group (n = 30). The former received acupuncture combined with moxibustion, while the latter was orally administered fluoxetine hydrochloride capsules. Both groups were treated for 8 weeks. Results showed that the total effective rate was 92.86% in the acupuncture group, superior to 81.48% in the medication group (p < 0.05). Additionally, HAMD-17 and SDS scores decreased more significantly in the acupuncture group (p < 0.05), with faster onset and fewer adverse reactions. Li and Ji (2022) applied cognitive-behavioral therapy combined with acupuncture in treating depressed university students, achieving a total effective rate of 88.57%, and reducing Hamilton Depression Rating Scale (HAMD) and Self-rating Depression Scale (SDS) scores. Some scholars (Yu et al., 2019) believe that adolescent depression is closely related to impaired function of the Shaoyang channel as a pivot. Based on the theory of “Shaoyang as the pivot,” treating adolescent depression should focus on the Shaoyang channel, using acupuncture to regulate and smooth the qi flow of the Shaoyang channel, thereby facilitating the pivot function. Acupuncture points such as Fengchi, Fengfu, Tianzhu, Wangu, Yifeng, and Tianyou were selected to achieve the therapeutic effects of unblocking the Shaoyang channel, regulating the pivot function, and soothing emotions. Li and Yan (2016) analyzed and concluded that intervention with both medication and acupuncture therapy for university student depression yields more stable and rapid therapeutic effects with lower recurrence rates compared to other treatments (Table 3).