摘要
本論文之宗旨是從傳統固有成方中，尋找安全、有效之抗痤瘡藥物，並且開發外用新劑型，以增加使用便利性，提高患者對中藥之接受度。首先，利用全民健保資料庫搜尋出常用抗痤瘡固有成方，排名依序為清上防風湯、真人活命飲、加味逍遙散、五味消毒飲、黃連解毒湯、龍膽瀉肝湯、荊芥連翹湯、溫清飲、散腫潰堅湯及消風散。接著，利用抗痤瘡基礎試驗評估其抗菌及抗發炎之能力。結果發現：溫清飲50%酒精萃取物對痤瘡桿菌(Propionbacterium acnes, P. acnes) 、P. acnes誘導RAW 264.7細胞或大鼠耳朵之發炎現象，具有良好的抑制效果。繼而利用痤瘡療效篩選平台探討，溫清飲50%酒精萃取物之抗痤瘡作用，發現其亦可抑制testosterone誘導角質細胞過度增生，以及促進aromatase活化之作用。而探討溫清飲之配伍組成，發現黃連解毒湯在溫清飲中，扮演抗菌及抗發炎之角色；而四物湯在溫清飲中，則扮演促進aromatase活化之角色。故此，未來於臨床應用上，若患者之病因為細菌過度孳生與發炎反應，可增加黃連解毒湯於外用軟膏中之比例；若為荷爾蒙失調之緣故，則可增加四物湯之比例，以發揮溫清飲最好之抗痤瘡療效。
並列摘要
The aim of this study is to find a safe and effective anti-acne drug from traditional Chinese prescriptions. We first identified 9 mostly commonly used Chinese prescriptions for the treatment of acne from National Health Insurance Research Database (NHIRD): Ching Shan Fang Feng Tang, Zen Ren Huo Ming Yin, Jia Wei Xiao Yao San, Huang Lian Jie Du Tang (HLJDT), Long Dan Xie Gan Tang, Jing Jie Lian Qiao Tang, Uen Ching Yiin (UCY), Sann Joong Kuey Jian Tang and Shiau Feng San. Antibacterial and anti-inflammatory activities of the extracts of these prescriptions were investigated. The results showed that 50% ethanol UCY extract had significant inhibitory effect on Propionibacterium acnes (P. acnes) proliferation and P. acnes–induced RAW 264.7 cell or rat ear inflammatory reactions. UCY also showed great anti-proliferative effect on HaCaT cell and promoted aromatase activity. The anti-acne effect of the composition of UCY was investigated too. HLJDT, a composition of UCY, played an important role in anti-P. acnes and anti-inflammatory effect; SWT, another composition of UCY, stimulated aromatase activity. In conclusion, the ratio of HLJDT and SWT in UCY could be adjusted according to which clinical effects (anti-inflammation, anti-bacterial or inhibition of testosterone over-secretion) work best for the patients.