Xia & He Publishing Inc. Mar 7 2025 Background and objectives Recent studies have highlighted a link between amyotrophic lateral sclerosis (ALS) and gut microbiota . This prospective study aimed to evaluate the effects of electroacupuncture combined with Chinese herbal medicine on gut microbiota and metabolomics in ALS patients. Methods Ten ALS patients were randomly assigned to either a treatment group (electroacupuncture with Chinese herbal medicine, n = 6) or a control group (waiting