Abstract： Objective:To study the clinical efficacy of live combined bacillus subtilis and enterococcus faecium enteric-coated capsules in the treatment of helicobacter pylori(Hp)eradication on the basis of standard quadruple regimen containing ilaprazole enteric coated tablet, and to compare the differences of drug-related adverse reactions.Methods:This study was a retrospective study, a total of 600 patients diagnosed as chronic gastritis or peptic ulcer by gastroscopy were selected from the outpatient clinic and gastroenterology department of the People′s Hospital of Ningxia Hui Autonomous Region from January 2020 to December 2021 who stopped antibiotics and bismuth for 4 weeks and stopped proton pump inhibitors(PPI)for more than 2 weeks after the first Hp eradication treatment, 14C breath test or gastroscopic pathological examination confirmed that Hp was still positive, 265 males and 335 females, the age was(42.91±12.96)years old, ranging from 18 to 80 years old.Patients were divided into quadruple regimen group( n=317)and probiotic group( n=283)according to whether probiotics were added.The quadruple regimen group was treated with standard quadruple regimen containing eprazole for Hp eradication, while the probiotic group was treated with Bacillus subtilis combined with live bacteria capsules at the beginning of the treatment.The eradication rate and adverse reactions were compared between the two groups. Results:The eradication success rate of Hp intent-to-treat analysis in probiotics group[82.7%(234/283)]was higher than that in quadruple regimen group[73.5%(233/317)], and the eradication success rate of Hp per-protocol analysis in probiotics group[87.6%(234/267)]was higher than that in quadruple regimen group[78.5%(233/297)], the differences were statistically significant( P<0.05). The incidence of adverse reactions in probiotics group[4.9%(13/267)]was lower than that in quadruple regimen group[17.2%(51/297)], and the difference was statistically significant( P<0.05). Conclusions:The standard quadruple therapy containing ilaprazole has a good eradication rate in the treatment of patients who fail to eradicate Helicobacter pylori for the first time.At the same time, combined with probiotics can further improve the success rate of the second eradication, effectively reduce the adverse drug reactions of patients and improve their compliance, which is worthy of clinical recommendation.