Objective To compare the efficacy and safety of Saccharomyces boulardii sachets and bismuth in the treatment of chronic gastritis and duodenal ulcer patients with Helicobacter pylori (Hp)infection.Methods A total of 176 patients with chronic gastritis or duodenal ulcer with Hp infection were enrolled.Patients with chronic gastritis (n=116) were randomly divided into the treatment group (58 cases) and the control group (58 cases): treatment group received triple therapy(rabeprazole+amoxicillin +levofloxacin) and Saccharomyces boulardii sachets for 14 days;control group received triple therapy and colloidal bismuth pectin for 14 days.Patients with duodenal ulcer (n=60) were ulcer group,given with bismuth-containing quadruple therapy for 14 days,then rabeprazole for 14 days.All patients were tested for 13 C urea breath test four weeks after stopping treatment.Results One hundred and seventy cases completed the trial.Hp eradication rate was 84.5%in treatment group,87.9% in control group,and 90.0% in ulcer group (analysis by intent of treatment,ITT analysis).The difference between the three groups was not statistically significant(P>0.05).The incidence of adverse events was significantly lower in treatment group (10.3%)than in control group (20.7%)and ulcer group (21.7%)(P<0.05).Conclusion Quadruple therapy with Saccharomyces boulardii sachets can effectively eradicate Hp.It can reduce the occurrence of adverse reactions.