【Abstract】 Objective To compare the efficacy of standard triple and quadruple regimens in eradicating Helicobacter pylori (Hp) in patients with peptic ulcer and chronic gastritis. Methods From October 2016 to March 2018, 320 patients with chronic gastritis, gastric ulcer or duodenal ulcer were diagnosed by gastroscopy in our hospital. 320 patients were divided into clarithromycin + metronidazole + omeprazole (CMO) group, clarithromycin + amoxicillin + omeprazole (CAO) group, clarithromycin + metronidazole + omeprazole + pectin bismuth (CMOP) group, clarithromycin + amoxicillin + omeprazole + pectin bismuth (CAOP) group, 80 cases in each group. Hp eradication rate, clinical symptom relief and adverse reactions were compared between the four groups. In addition, the costeffectiveness ratio (C/E) was analyzed. The cost/effectiveness of different treatment regimens was compared with that of CMO group, and △C/△E=(C1C2)/(E1E2) was calculated. Results On the 1st, 7th and 14th day after treatment, the symptoms of the four groups were relieved to the same extent, and there was no significant difference between the groups (P＞005). After treatment, the eradication rates of HP in the four groups were 7000% (56/80), 7250% (58/80), 9125% (73/80) and 9375% (75/80), respectively. The eradication rates of Hp in CMOP and CAO P groups were higher than those in CMO and CAO groups (P＜005). The incidence of adverse reactions was 375%, 250%, 250% and 375% respectively. There was no significant difference between the four groups (P＞005). C/E in group CMO, group CAO, group CMOP and group CAOP were 865, 851, 710 and 702 respectively. In group CMO, the △C/△E of group CAO, group CMOP and group CAOP were 451, 198 and 248 respectively. Conclusion The Hp eradication rate of bismuth containing quadruple regimen is higher than that of the triplet scheme, and the side effect is small and economical.