Objective To evaluate the effect of electroacupuncture at Chize and Shangjuxu on the prognosis and respiratory dynamics in patients with acute respiratory distress syndrome(ARDS).Methods A prospective randomized controlled study was conducted to collect patients with ARDS admitted to the Department of Emergency Medicine of Tongde Hospital of Zhejiang Province from December 2020 to September 2022.A total of 142 patients with ARDS from the Department of Emergency Medicine of Tongde Hospital of Zhejiang Province were selected for this study.Seven patients were excluded due to rapid deterioration,3 patients withdrew the informed consent,and finally 132 patients were enrolled.According to the order of enrollment,they were randomly divided into the electroacupuncture group and the conventional treatment group based on the random number table.The conventional treatment group received conventional treatment for ARDS,while the electroacupuncture group combined with electroacupuncture at Chize and Shangjuxu,the treatment lasted for 30 minutes.The mortality at day 60 and secondary efficacy indicators such as hospital stay,ventilator-free days at 28 day,and mechanical ventilation time of two groups were compared,and the indicators of respiratory mechanics and oxygenation such as inhalation oxygen concentration(FiO2),tidal volume(VT),positive end-expiratory pressure(PEEP),plateau pressure(Pplat),lung static compliance(Cst),oxygenation index(PaO2/FiO2)were also compared.Then the Kaplan-Meier survival curves were drawn to compare the differences in cumulative survival rates within 60 days between the two groups.Results The mortality at day 60 in the electroacupuncture group was lower than that in the conventional treatment group[33.33％(22/66)vs.40.91％(27/66)],but the difference was not statistically significant(P>0.05),and the hospital stay in the electroacupuncture group was significantly shorter than that in the conventional treatment group(days:25.09±11.57 vs.30.21±15.94,P<0.05).The ventilator-free days at 28 days in the electroacupuncture group were significantly higher than those in the conventional treatment group(days:10.06±7.35 vs.7.67±5.72,P<0.05).There was no statistically significant difference in mechanical ventilation time between the two groups(days:15.70±9.05 vs.18.39±9.55,P>0.05).After 72 hours of treatment,the FiO2,VT,and PaCO2 levels in the electroacupuncture group were significantly lower than those in the conventional treatment group[FiO2:0.39±0.07 vs.0.44±0.09,VT(mL/kg):6.27±0.74 vs.6.62±0.74,PaCO2(mmHg,1 mmHg≈0.133 kPa):39.94±4.52 vs.41.95±4.19,all P<0.05].Conclusion Electroacupuncture at Chize and Shangjuxu can effectively shorten the course of ARDS and improve prognosis,which may be related to the improvement of respiratory dynamics by electroacupuncture treatment.