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目的：观察含铋剂的四联疗法7 d、10 d及标准三联对根除幽门螺杆菌（H. pylori, HP）感染的疗效。方法120例HP阳性的患者随机分为7 d四联治疗组（A组）、10 d四联治疗组（B组）和标准三联疗法对照组（C组）各40例。A组口服雷贝拉唑+克拉霉素+阿莫西林+枸橼酸铋钾胶囊，治疗7 d。B组口服雷贝拉唑+克拉霉素+阿莫西林+枸橼酸铋钾胶囊，治疗10 d。C组口服雷贝拉唑+克拉霉素+阿莫西林，治疗7 d。治疗结束4周后复查13C呼气试验，评估HP根除率。结果120例患者均完成抗HP治疗周期及随访。A、B、C三组的HP根除率分别为94.74%、91.67%、75.68%，三组比较差异具有统计学意义。临床症状改善率分别为97.37%、94.44%、97.30%，三组比较差异无统计学意义。不良反应发生率分别为15.79%、16.67%、18.92%，组间比较差异无统计学意义，普遍均能耐受。结论铋剂四联疗法较标准三联疗法可显著提高HP根除率，不增加不良反应发生率，是一种可供选择的一线治疗方案。“,”ObjectiveTo compare the effectiveness of bismuth pectin quadruple 7 days, 10 days and standard triple therapies for H. pylori (HP) eradication.Methods Total of 120 HP-positive patients were enrolled in the study and randomly allocated into the following three groups: group A (n=40) received a 7 days bismuth pectin quadruple therapy (20 mg rabeprazole qd, 1,000 mg amoxicillin bid, 220 mg bismuth pectin bid, and 500 mg clarithromycin bid); group B (n=40) received a 10 days bismuth pectin quadruple therapy (20 mg rabeprazole qd, 1,000 mg amoxicillin bid, 220 mg bismuth pectin bid, and 500 mg clarithromycin bid); group C (n=40) received a standard 1-week triple therapy (20 mg rabeprazole qd, 1,000 mg amoxicillin bid, 500 mg clarithromycin bid). After 4 weeks treatment, the13C breath test was repeated to evaluate the eradication rate of HP.Results 120 patients were treated with anti HP treatment cycle and follow-up. The eradication rates of three groups were 94.74%, 91.67% and 75.68% respectively. The difference was statistically significant. The clinical symptom improvement rate was 97.37%, 94.44%, 97.30%, the difference was not statistically signifi cant between the three groups. The incidence of adverse reactions was 15.79%, 16.67%, 18.92%, the difference was not statistically signifi cant, and it was generally tolerated.Conclusion Bismuth quadruple therapy compared with standard triple therapy can signifi cantly improve the eradication rate of HP, does not increase the incidence of adverse reactions, is a choice offi rst-line treatment.