KARYA TULIS AKHIR PENGARUH PEMBERIAN KOMBINASI …eprints.umm.ac.id/46804/1/PENDAHULUAN.pdfkarya tulis akhir . pengaruh pemberian kombinasi ekstrak jahe, kayu manis, dan cengkih terhadap

KARYA TULIS AKHIR

PENGARUH PEMBERIAN KOMBINASI EKSTRAK JAHE, KAYU MANIS, DAN

CENGKIH TERHADAP KADAR SGOT DAN SGPT PADA TIKUS YANG

DIINDUKSI STREPTOZOTOCIN

Oleh

FADHILLAH AINURROHMAH HARIANTO

201510330311110

FAKULTAS KEDOKTERAN

UNIVERSITAS MUHAMMADIYAH MALANG

2018

ii

PENGARUH PEMBERIAN KOMBINASI EKSTRAK JAHE, KAYU MANIS, DAN

CENGKIH TERHADAP KADAR SGOT DAN SGPT PADA TIKUS YANG

DIINDUKSI STREPTOZOTOCIN

KARYA TULIS AKHIR

Diajukan kepada

Universitas Muhammadiyah Malang

untuk Memenuhi Salah Satu Persyaratan

dalam Menyelesaikan Program Sarjana

Fakultas Kedokteran

Oleh:

Fadhillah Ainurrohmah Harianto

201510330311110

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2018

iv

PERNYATAAN ORISINALITAS

Karya tulis akhir ini adalah karya saya sendiri, dan semua sumber baik yang dikutip maupun

dirujuk telah saya nyatakan dengan benar.

Nama : Fadhillah Ainurrohmah Harianto

NIM : 201510330311110

Malang, 8 Januari 2019

Penulis

vi

KATA PENGANTAR

Alhamdulillahirabbil’alamin, puji dan syukur penulis panjatkan kehadirat Tuhan Yang

Maha Esa serta dengan berkat dan rahmat-Nya sehingga tugas akhir penulis dengan judul

“Pengaruh Pemberian Kombinasi Ekstrak Jahe, Kayu Manis dan Cengkih terhadap kadar

SGOT dan SGPT tikus yang diinduksi Streptozotocin” dapat terselesaikan dengan baik.

Segala sesuatu yang benar dalam tugas akhir ini datang dari Allah SWT, dan segala

kekeliruan dalam penulisan ini datangnya dari diri penulis sendiri.

Dalam penyelesaian tugas akhir ini penulis banyak mengalami kesulitan, tetapi berkat

dukungan, bimbingan, dan bantuan dari dosen pembimbing dalam rangka penyusunan dan

dorongan dari berbagai pihak akhirnya penulis dapat menyelesaikan tugas akhir ini tepat pada

waktunya.

Penulis menyadari bahwa karya tulis akhir ini masih belum sempurna, sehingga masih

membutuhkan saran dari berbagai pihak. Penulis berharap skripsi ini dapat menjadi wujud

ibadah penulis kepada Zat Yang Maha Mengetahui lagi Bijaksana, dan dapat memberikan

manfaat bagi para pembaca.

Malang,

Penulis

vii

UCAPAN TERIMA KASIH

Pada kesempatan ini, penulis menyampaikan terimakasih yang sebesar- besarnya

Kepada:

1. Kedua orang tua saya, Bapak Bambang Harianto dan Ibu Dewi Asih yang telah

memberikan kasih sayang, dukungan moral dan materi, semangat, perhatian serta

limpahan doanya selama ini.

2. Dr. dr. Meddy Setiawan, Sp.PD, selaku Dekan Fakultas Kedokteran Universitas

Muhammadiyah Malang.

3. dr. Moch Ma’roef, Sp.OG selaku Pembantu Dekan I Fakultas Kedokteran Universitas

Muhammadiyah Malang.

4. dr. Sri Adilla Nurainiwati, Sp.KK, selaku Pembantu Dekan II Fakultas Kedokteran

Universitas Muhammadiyah Malang.

5. dr. Indra Setiawan, Sp.THT selaku Pembantu Dekan III Fakultas Kedokteran

Universitas Muhammadiyah Malang.

6. Dr. dr. Fathiyah Safithri, M.Kes selaku Kepala Program Studi Pendidikan Kedokteran

Fakultas Kedokteran Universitas Muhammadiyah Malang.

7. dr. Gita Sekar Prihanti, M.Pd.Ked, selaku dosen pembimbing I yang telah

meluangkan waktu dan penuh kesabaran memberikan bimbingan, inspirasi dan

masukan dalam menyelesaikan tugas akhir ini.

8. Dr. dr. Fathiyah Safithri, M.Kes, selaku dosen pembimbing II yang telah meluangkan

waktu dan penuh kesabaran memberikan bimbingan, inspirasi dan masukan dalam

menyelesaikan tugas akhir ini.

9. dr. Ardhi Bustami, Sp.PD, selaku dosen penguji yang telah meluangkan waktu dan

memberikan banyak masukan untuk menyelesaikan tugas akhir ini.

viii

10. Adikku tersayang Fahim yang telah memberikan dukungan, semangat dan doanya

untuk kelancaran tugas akhir ini.

11. Staff TU, Bu Endah, Mbak Nuke, Mbak citra, Pak Heri, Mas Joko, Mas Didit, Mas

Burhan yang telah membantu administrasi penulis dalam menyelesaikan TA.

12. Staff Biomedik dan Skill, Bu Fat, Pak Joko, Mas Nyono, Mas Miftah, Pak Kus dan

Mbak Dilla yang telah membantu administrasi penulis dalam menyelesaikan TA.

13. Teman teman Rempah-Rempah Cinta Badzlina, Nesrin, Zaza, Siska, Atik, Irma,

Mano, Ully, dan Devi yang telah berjuang bersama dalam mengerjakan tugas akhir

ini.

14. Teman-teman Yeoja Chingu Via, Atik, dan Novi yang telah memberikan dukungan,

motivasi, mengingatkan dalam kebaikan dan berjuang bersama selama masa

perkuliahan.

15. Seluruh teman-teman “Metacarpal” angkatan 2015 FK UMM yang tidak bisa

disebutkan satu persatu. Terima kasih atas segala bantuan, motivasi, doa selama

perkuliahan. Semoga kita semua menjadi dokter yang bermaanfaat bagi agama,

bangsa, dan negara. Amin.

16. Keluarga besar TBMM Nurul Qolbi dan teman-teman diklat 13 FK UMM, Lili, Titis,

Karimah, Ukang dan teman-teman yang lain yang memberikan warna warni selama

berada di perkuliahan.

17. Keluarga Kemendesma BEM UMM periode Kabinet Hebat 2016/2017, Moh. Ihsan

Zain dan kawan-kawan yang telah senantiasa memberikan motivasi dalam

menyelesaikan tugas akhir ini.

18. KKN PPM 04 UMM, Dedi, Huri, Cyntia, Azka dan kawan-kawan yang sudah

memberi kecerian dan semangatnya dalam mengerjakan.

ix

19. Para dosen pengajar FK UMM yang telah memberikan bekal ilmu dan pengetahuan.

20. Semua pihak yang turut membantu dalam menyelesaikan karya tulis ini dan juga

mendoakan demi suksesnya karya tulis ini yang tidak bisa penulis sebutkan satu-

persatu.

Penulis menyadari sepenuhnya bahwa tidak ada sesuatu yang sempurna di dunia ini

sehingga penulis sangat mengharapkan masukan dari berbagai pihak. Semoga tugas akhir

ini sebagai suatu karya tulis ilmiah dapat bermanfaat bagi semua pihak.

Malang,

Penulis

x

DAFTAR ISI

Halaman

LEMBAR PENGESAHAN ................................................................................... iii

HALAMAN PERNYATAAN ORISINALITAS ................................................... iv

LEMBAR PENGUJI ................................................................................................ v

KATA PENGANTAR............................................................................................vi

UCAPAN TERIMAKASIH .................................................................................. vii

ABSTRAK ............................................................................................................... x

ABSTRACT .............................................................................................................. xi

DAFTAR ISI .........................................................................................................xii

DAFTAR TABEL ................................................................................................ xvii

DAFTAR GAMBAR ......................................................................................... xviii

DAFTAR SINGKATAN ...................................................................................... xix

DAFTAR LAMPIRAN .......................................................................................... xx

BAB 1 PENDAHULUAN ...................................................................................... 1

1.1 Latar Belakang ................................................................................................... 1

1.2 Rumusan Masalah .............................................................................................. 3

1.3 Tujuan Penelitian ............................................................................................... 4

1.3.1 Tujuan Umum .......................................................................................... 4

1.3.2 Tujuan Khusus ......................................................................................... 4

1.4 Manfaat Penelitian ............................................................................................. 5

1.4.1 Manfaat Akademik .................................................................................. 5

1.4.2 Manfaat Klinis ......................................................................................... 5

1.4.3 Manfaat Masyarakat ................................................................................ 5

BAB 2 TINJAUAN PUSTAKA ............................................................................ 6

2.1 Hiperglikemi ..................................................................................................... 6

2.1.1 Definisi Hiperglikemi ............................................................................. 6

2.1.2 Epidemiologi Hiperglikemi .................................................................... 6

2.1.3 Tanda dan Gejala Hiperglikemi ............................................................... 7

2.1.4 Klasifikasi Hiperglikemi..........................................................................8

xi

2.1.5 Patofisiologi Hiperglikemi.......................................................................8

2.1.6 Terapi Hiperglikemi................................................................................9

2.1.7 Komplikasi Hiperglikemi.......................................................................11

2.2 Jahe .................................................................................................................. 13

2.2.1 Taksonomi Jahe......................................................................................13

2.2.2 Morfologi Jahe ....................................................................................... 14

2.2.3 Kandungan Jahe ..................................................................................... 15

2.3 Kayu Manis ...................................................................................................... 16

2.3.1 Taksonomi Kayu Manis ......................................................................... 16

2.3.2 Morfologi Kayu Manis .......................................................................... 17

2.3.3 Kandungan Kayu Manis ........................................................................ 17

2.4 Cengkih ............................................................................................................ 19

2.4.1 Taksonomi Cengkih ............................................................................... 19

2.4.2 Morfologi Cengkih ............................................................................... 20

2.4.3 Kandungan Cengkih .............................................................................. 21

2.5 Hepar ................................................................................................................ 22

2.5.1 Anatomi ................................................................................................. 23

2.5.2 Fisiologi hepar ....................................................................................... 24

2.5.3 Metabolisme Lemak Hepar .................................................................... 24

2.5.4 Gangguan hepar pada Hiperglikemi ...................................................... 25

2.6 Enzim Transaminase ........................................................................................ 26

2.6.1 Enzim transaminase pada hiperglikemi ................................................. 26

2.7 Oksidatif stress pada Hiperglikemi .................................................................. 28

2.7.1 Peran ROS dalam oksidatif stress .......................................................... 28

2.8 Streptozotocin .................................................................................................. 31

2.9 Pengaruh kombinasi jahe, kayu manis dan cengkih untuk mencegah hiperglikemi dan

gangguan hepar ...................................................................................................... 34

BAB 3 KERANGKA KONSEP DAN HIPOTESIS .......................................... 35

3.1 Kerangka konseptual penelitian ....................................................................... 36

3.2 Hipotesis .......................................................................................................... 37

BAB 4 METODE PENELITIAN ........................................................................ 38

xii

4.1 Jenis penelitian ................................................................................................. 38

4.2 Lokasi dan waktu penelitian ............................................................................ 38

4.3 Populasi dan sampel ......................................................................................... 38

4.3.1 Populasi .................................................................................................. 38

4.3.2 Sampel ................................................................................................... 38

4.3.3 Besar Sampel ......................................................................................... 38

4.3.4 Teknik Pengambilan Sampel ................................................................. 40

4.3.5 Karakteristik Sampel Penelitian............................................................. 40

4.3.6.1 Kriteria Inklusi ............................................................................... 40

4.3.6.2 Kriteria Eksklusi............................................................................. 40

4.3.6.3 Kriteria drop out ............................................................................. 40

4.3.6 Variabel Penelitian ................................................................................. 40

4.3.6.1 Variabel Bebas ............................................................................... 40

4.3.6.2 Variabel Tergantung....................................................................... 41

4.3.7 Definisi Operasional .............................................................................. 41

4.4 Alat dan Bahan Penelitian ................................................................................ 46

4.4.1 Alat dan bahan ekstrak jahe ................................................................... 46

4.4.2 Alat dan bahan ekstrak kayu manis ....................................................... 46

4.4.3 Alat dan bahan ekstrak cengkih ............................................................. 47

4.4.4 Alat dan bahan Pemeliharaan tikus ........................................................ 47

4.4.5 Alat dan bahan induksi .......................................................................... 47

4.4.6 Alat dan bahan bedah tikus .................................................................... 48

4.4.7 Alat dan Bahan Pemeriksaan SGOT dan SGPT .................................... 48

4.4.8 Alat dan bahan lain ................................................................................ 48

4.5 Prosedur penelitian........................................................................................... 49

4.5.1 Adaptasi ................................................................................................. 49

4.5.2 Pembagian kelompok tikus .................................................................... 49

4.5.3 Induksi Streptozotocin ........................................................................... 51

4.5.4 Pembuatan ekstrak jahe, kayu manis, dan cengkih ................................ 51

4.5.5 Penentuan Dosis ..................................................................................... 51

xiii

4.5.6 Proses Anastesi dan Pembedahan Hewan Coba .................................... 52

4.5.7 Pembuatan Sediaan dan Pengukuran.....................................................52

4.5.8 Perlakuan Setelah Tindakan Pada Hewan Coba....................................53

4.6 Alur Penelitian.................................................................................................54

4.7 Analisis Data .................................................................................................... 58

BAB 5 HASIL PENELITIAN DAN ANALISIS DATA...................................59

5.1 Hasil Penelitian................................................................................................59

5.2 Analisis Data....................................................................................................65

BAB 6 PEMBAHASAN.......................................................................................66

BAB 7 KESIMPULAN DAN SARAN................................................................72

7.1 Kesimpulan ..................................................................................................... 72

7.2 Saran ................................................................................................................ 72

DAFTAR PUSTAKA...........................................................................................73

LAMPIRAN..........................................................................................................83

xiv

DAFTAR TABEL

Halaman

4.1 Definisi Operasional .......................................................................................46

5.1 Pengaruh pemberian kombinasi ekstrak jahe, kayu manis dan cengkih pada tikus model

hiperglikemi dan gangguan hepar terhadap kadar SGOT

(U/L)..................................................................................................................64

5.2 Pengaruh pemberian kombinasi ekstrak jahe, kayu manis dan cengkih pada tikus model

hiperglikemi dan gangguan hepar terhadap

kadar SGPT (U/L).............................................................................................65

5.3 Uji Normalitas kadar SGOT dan SGPT tikus putih........................................68

5.4 Uji homogenitas kadar SGOT dan SGPT tikus putih.....................................68

5.5 Uji Normalitas kadar SGOT dan SGPT yang telah di transformasi...............69

5.6 Uji Homogenitas kadar SGOT dan SGPT yang telah di transformasi...........70

5.7 Hasil Uji Kruskal Wallis data SGOT dan SGPT............................................70

xv

DAFTAR GAMBAR

Halaman

2.1 Mekanisme kerja sulfonilurea ..........................................................................13

2.2 Metabolisme karbohidrat dan proses yang menyebabkan diabetes.................16

2.3. Tanaman jahe dan rimpang jahe .....................................................................18

2.4 Komponen antioksidan dan total antioksidan pada jahe dengan pelarut yang berbeda

........................................................................................................................19

2.5 Morfologi dan pelepah kayu manis ..................................................................20

2.6 Struktur polifenol Cinnamomum zeylanicum...................................................21

2.7 Komponen fitokimia pada tiap bagian yang berbeda pada kayu manis ...........21

2.8 Komposisi nutrisi Cinnamomum zeylanicum dan Cinnamomum cassia .........22

2.9 Morfologi dan bunga cengkih ..........................................................................24

2.10 Kandungan cengkih (Syzygium aromaticum) dalam ekstrak etanol ..............25

2.11 Struktur Kimia Enzim Transaminase .............................................................31

2.12 Struktur kimia Streptozotocin ........................................................................36

4.1 Alur Penelitian .................................................................................................60

5.1A. Grafik Rerata Pengaruh pemberian kombinasi ekstrak jahe, kayu manis dan cengkih

pada tikus model hiperglikemi dan gangguan hepar terhadap kadar

SGOT..............................................................................................................66

5.1B. Grafik Rerata Pengaruh pemberian kombinasi ekstrak jahe, kayu manis dan cengkih

pada tikus model hiperglikemi dan gangguan hepar

terhadap kadar SGPT.....................................................................................67

xvi

DAFTAR SINGKATAN

ADA : American Diabetes Association

DM : Hiperglikemi

CAT : Katalase

OAD : Obat Anti Diabetes

ROS : Reactive Oxygen Species

SOD : Superoxide dismutase

STZ : Streptozotocin

WHO : World Health Organization

GSH : Glutathione

Trx : thioredoxin

CAT : katalase

SOD : Superoxida dismutase

iNOS : inducible Nitric Oxygenase Syntase

xvii

DAFTAR LAMPIRAN

Lampiran 1 Tabel Kadar Serum SGOT dan SGPT tikus model hiperglikemi dan gangguan

hepar ............................................................................................................... 87

Lampiran 2 Analisis Data ................................................................................................... 88

Lampiran 3 Dokumentasi Kegiatan Penelitian .................................................................. 91

Lampiran 4 Surat Keterangan Lolos Komisi Ilmiah ........................................................... 95

Lampiran 5 Surat Etik Penelitian ........................................................................................ 96

Lampiran 6 Surat Keterangan Ekstrak ............................................................................... 97

Lampiran 7 Kartu Konsultasi Tugas Akhir ........................................................................ 98

Lampiran 8 Surat Keterangan Lolos Plagiasi.....................................................................99

xviii

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