The quake, which struck northwest China just before midnight on Monday, has killed at least 117 people in Gansu province and 31 in neighbouring Qinghai, the official Xinhua News Agency said.
More than 139,000 people have been moved to emergency shelters across the two provinces, according to state broadcaster CCTV, which said rescuers in Gansu were "fully shifting the focus of their work toward resettling affected populations and treating the injured".
But emergency response teams were still searching for trapped victims in Qinghai on Friday morning, according to CCTV.
People were buried alive in Qinghai's Zhongchuan township on Tuesday after a "sand boil" -- a phenomenon that can occur during an earthquake when soil liquefies and forces sand and water out of the ground.
The quake was China's deadliest since 2014, when more than 600 people were killed in southwestern Yunnan province.
Almost 1,000 were injured across the two provinces after the shallow tremor on Monday, measured at 5.9 by the US Geological Survey.
Dozens of smaller aftershocks followed.
Subzero temperatures have made the aid operation even more challenging, with AFP reporters seeing survivors huddle around outdoor fires to keep warm in the day after the quake.
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