Objective: To observe the clinical effect of five-element music therapy on the improvement of anxiety and depression in patients with chronic hepatitis B (CHB) (liver depression and spleen deficiency syndrome). Methods: A total of 76 patients with CHB admitted to our hospital from January 2019 to June 2020 were randomly divided into a control group and an observation group, 38 cases in each group. The patients in the control group were given routine treatments such as liver protection, enzyme lowering and antiviral therapy, as well as health education and emotional comfort. The patients in the observation group were given five-element music therapy that derives from traditional Chinese medicine on the basis of the treatment routine in the control group. A course of treatment was 7 d, and the treatment lasted for 3 courses. Scores of anxiety, depression and TCM syndrome score were compared, and the level of alanine aminotransferase (ALT) was detected. Results: After 1 month, 3 months and 6 months of treatment, the SAS scores of patients in the observation group were significantly lower than those in the control group. The differences were statistically significant (P<0.05). The SDS scores were also significantly decreased (P<0.05). The TCM syndrome scores of the observation group were significantly decreased (P<0.05). The liver function index ALT was improved in both groups, and the level of ALT in the observation group was relatively low, but the difference was not statistically significant (P>0.05). Conclusion: Five-element music therapy is beneficial to improve the anxiety and depression symptoms of patients with CHB (liver depression and spleen deficiency syndrome), and reduce the clinical symptoms of patients.