KARYA TULIS AKHIR

Pengaruh Ekstrak Jahe Merah ( Zingiber officinale Roscoe ) terhadap Gambaran IL-6

pada Tikus Putih (Rattus norvegicus) Strain Wistar yang diinduksi oleh Pirazinamid,

Etambutol, Levofloksasin

OLEH

AGRA MEDHA WISESA

201510330311177

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2019

Pengaruh Ekstrak Jahe Merah ( Zingiber officinale Roscoe ) terhadap Gambaran IL-6

pada Tikus Putih (Rattus norvegicus) Strain Wistar yang diinduksi oleh Pirazinamid,

Etambutol, Levofloksasin

KARYA TULIS AKHIR

Diajukan kepada

Universitas Muhammadiyah Malang

Untuk Memenuhi Salah Satu Persyaratan

Dalam Menyelesaikan Program Sarjana

Fakultas Kedokteran

Oleh:

Agra Medha Wisesa

201510330311177

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2019

LEMBAR PENGESAHAN

LAPORAN HASIL PENELITIAN

PERNYATAAN ORISINALITAS

KATA PENGANTAR

Assalamu’alaikum Warahmatullah Wabarakatuh

Puji syukur kehadirat Allah Subhanahu wata’ala Yang Maha Pengasih lagi Maha

Penyayang dan atas karunia-Nya, penulisan tugas akhir ini dapat selesai dengan baik. Shalawat

serta salam selalu tercurahkan kepada Rasulullah Muhammad shalallahu alaihi wasallam,

keluarganya dan para sahabatnya yang telah berjasa membawa syiar dakwah Islam ke seluruh

dunia.

Penelitian tugas akhir ini berjudul Pengaruh Ekstrak Jahe Merah ( Zingiber officinale

Roscoe ) terhadap Gambaran IL-6 pada Tikus Putih (Rattus norvegicus) Strain Wistar yang

diinduksi oleh Pirazinamid, Etambutol, Levofloksasin. Tugas akhir ini diajukan untuk

memenuhi persyaratan Pendidikan Sarjana Fakultas Kedokteran Universitas Muhammadiyah

Malang.

Penulis menyadari tugas akhir ini masih jauh dari kata sempurna, oleh karena itu,

penulis sangat mengharapkan saran dan masukan yang membangun. Semoga karya tulis ini

dapat menambah wawasan keilmuan dan bermanfaat bagi semua pihak.

Wassalamu’alaikum Warahmatullah Wabarakatuh

Malang, 18 Juli 2019

Penulis

UCAPAN TERIMAKASIH

1. Bapak Djoko Wahjoediono, Ibu Nurjati, Kakak Kallida Nariswari, Kakak

Adhyaksa Mahardika dan Kembaran saya Pramodana Medha Wisesa, atas

dukungan moril dan materiil, juga telah menjadi sumber semangat penulis

untuk bisa menyelesaikan tugas akhir ini.

2. dr. Thontowi Djauhari, NS., M.Kes, selaku pembimbing 1, atas kesabaran,

kebaikan hati, serta kesediaan dalam meluangkan waktu serta membimbing

penulis sehingga tugas akhir ini dapat diselesaikan dengan baik.

3. dr. Feny Tunjungsari, M.Kes, selaku pembimbing 2, atas kesabaran, kebaikan

hati, serta kesediaan dalam meluangkan waktu serta membimbing penulis

sehingga tugas akhir ini dapat diselesaikan dengan baik.

4. dr. Anung Putri Illahika, M.Si, selaku penguji tugas akhir ini, atas segala

masukan dan arahan yang sangat bermanfaat dalam pengerjaan tugas akhir

sehingga tugas akhir ini dapat diselesaikan dengan baik.

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

Universitas Muhammadiyah Malang atas ilmu dan bimbingannya selama di

Fakultas Kedokteran UMM.

6. dr. Moch. Ma’roef, Sp.OG, selaku Wakil Dekan I Fakultas Kedokteran UMM

atas kesediaan waktu dan penyampaian ilmu yang sangat bermanfaat bagi

masa depan para mahasiswa FK UMM.

7. dr. Sri Adila Nurainiwati, Sp.KK, selaku Wakil Dekan II Fakultas Kedokteran

UMM yang senantiasa bersabar dalam membimbing dan mengajarkan

ilmunya kepada kami.

8. dr. Indra Setiawan, Sp.THT-KL, selaku Wakil Dekan III, yang penuh

semangat dalam menyampaikan ilmu dan motivasi yang membangun

semangat kami selama menjalani pendidikan di Fakultas Kedokteran.

9. MEARS (Medical and Health Research), dr. Anung Putri Ilahika, M.Si,

selaku komisi ilmiah Fakultas Kedokteran Universitas Muhammadiyah

Malang.

10. Seluruh staf TU dan laboran, Mas Nyono, Ibu Patma, Pak Joko dan Mas

Miftah yang bersedia membantu setiap tahapan proses penelitian hingga

tugas akhir ini selesai.

11. Muhammad Furkan, Abdillah Budi Ksatria dan Duwi Hikmatullah yang telah

menjadi teman terbaik dalam memberikan masukkan-masukkan yang

membangun dalam proses pengerjaan tugas akhir ini.

12. Alim Muhaimin dan Raffian Yusuf selaku teman yang tak pernah lelah

untuk selalu memotivasi dan mengingatkan agar selalu tetap dijalan

kebenaran.

13. Cendra Mulya sebagai kawan seperjuangan yang selalu memberikan

kekuatan dalam proses pengerjaan tugas akhir ini.

14. Sejawat FK UMM angkatan 2015, Metacarpal, atas dukungan, bantuan, dan

kerjasamanya. Semoga kelak dapat menjadi dokter-dokter profesional yang

selalu diberikan keberkahan dalam pengabdiannya, dan sukses dunia akhirat,

serta senaantiasa dalam ketaatan kepada Allah Subhanahu Wata’ala.

15. Semua pihak yang telah terlibat langsung maupun tidak langsung, terima

kasih atas bantuan dan dukungannya.

DAFTAR ISI

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

LEMBAR PENGUJIAN…………………………………………………………....……..iv

PERNYATAAN ORISINALITAS ................................................................................ v

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

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

DAFTAR ISI ................................................................................................................. ix

DAFTAR TABEL ......................................................................................................... xii

DAFTAR GAMBAR ..................................................................................................... xiii

DAFTAR SINGKATAN ............................................................................................... xiv

DAFTAR LAMPIRAN ................................................................................................. xv

ABSTRAK ..................................................................................................................... xvi

ABSTRACT................................................................................................................... xvii

BAB 1 PENDAHULIAN ............................................................................................... 1

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

1.2.Rumusan Masalah .............................................................................................. 2

1.3.Tujuan Penelitian................................................................................................ 2

1.3.1 Tujuan Umum ............................................................................................... 2

1.3.2 Tujuan Khusus .............................................................................................. 2

1.4.Manfaat Penelitian .............................................................................................. 3

1.4.1 Manfaat Akademis ........................................................................................ 3

1.4.2Manfaat Klinis................................................................................................ 3

1.4.3Manfaat Masyarakat ....................................................................................... 3

BAB 2 TINJAUAN PUSTAKA..................................................................................... 4

2.1. Pirazinamid (PZA/Z) ......................................................................................... 4

2.1.1. Definisi ........................................................................................................ 4

2.1.2. Efikasi pada manusia .................................................................................... 4

2.1.3. Keamanan dan efek samping ........................................................................ 4

2.2. Etambutol (EMB/E) ........................................................................................... 5

2.2.1. Definisi ........................................................................................................ 5

2.2.2. Efikasi pada manusia .................................................................................... 5

2.2.3. Keamanan dan efek samping ........................................................................ 6

2.3. Levofloxacin (Lfx) .............................................................................................. 6

2.3.1. Definisi ........................................................................................................ 6

2.3.2. Efikasi pada manusia .................................................................................... 7

2.3.3. Kemananan dan efek samping ...................................................................... 7

2.4. Respon Inflamasi ............................................................................................... 8

2.4.1. Pengertian Inflamasi ..................................................................................... 8

2.4.2. Proses Inflamasi Akut ................................................................................... 9

2.4.3. Proses Inflamasi Kronis .................................................................................. 10

2.5. Interleukin 6 (IL-6) ............................................................................................ 11

2.6. Jahe Merah (Zingiber officinale Roscoe.) ......................................................... 13

2.6.1. Taksonomi Jahe Merah ................................................................................ 13

2.6.2 Deskripsi Tanaman Jahe Merah ..................................................................... 14

2.6.3 Kandungan Jahe Merah ................................................................................. 14

2.6.4 Manfaat Jahe Merah ...................................................................................... 15

2.7. Tikus Putih (Rattus Novergicus) ....................................................................... 17

2.7.3. Taksonomi Tikus Putih ................................................................................. 17

2.7.4. Deskripsi Tikus Putih ................................................................................... 17

BAB 3 KERANGKA KONSEP .................................................................................... 18

3.1. Kerangka Konsep ................................................................................................... 18

3.2. Hipotesis Penelitian ................................................................................................ 20

BAB 4 METODE PENELITIAN .................................................................................. 21

4.1 Jenis dan Rancangan Penelitian ......................................................................... 21

4.2. Tempat dan Waktu Penelitian........................................................................... 21

4.3. Populasi dan Sampel .......................................................................................... 21

4.3.1 Populasi ........................................................................................................ 21

4.3.2 Sampel .......................................................................................................... 21

4.3.3 Besar Sampel ................................................................................................ 21

4.3.4 Teknik Sampling ........................................................................................... 23

4.4. Karakteristik sampel penelitian ........................................................................ 23

4.4.1. Kriteria Inklusi : ........................................................................................... 23

4.4.2. Kriteria Eksklusi :......................................................................................... 23

4.4.3. Kriteria drop out: .......................................................................................... 23

4.5. Variabel Penelitian ............................................................................................ 23

4.5.1. Variabel Bebas ............................................................................................. 23

4.5.2. Variabel Tergantung ..................................................................................... 23

4.6. Definisi Operasional........................................................................................... 24

4.7. Bahan dan Instrumen Penelitian ....................................................................... 24

4.7.1. Bahan ........................................................................................................... 24

4.7.2. Alat .............................................................................................................. 25

4.8. Prosedur Penelitian ............................................................................................ 26

4.8.1. Adaptasi ....................................................................................................... 26

4.8.2. Pengelompokan tikus.................................................................................... 27

4.8.3. Pembuatan sediaan ekstrak rimpang jahe merah ........................................... 28

4.8.4. Pemberian Ekstrak Rimpang Jahe Merah ...................................................... 28

4.8.5. Pemberian obat anti tuberkulosis .................................................................. 29

4.8.6. Proses Anastesi............................................................................................. 31

4.8.7. Pengukuran Kadar IL-6 ................................................................................ 31

4.8.8. Penanganan Hewan Coba ............................................................................. 31

4.9. Alur Penelitian ................................................................................................... 32

4.10. Teknik Pengumpulan Dan Analisis Data ........................................................ 33

4.10.1. Teknik Pengumpulan Data .......................................................................... 33

4.11. Analisis Data .................................................................................................... 33

4.12. Jadwal Penelitian ............................................................................................. 34

BAB 5 HASIL PENELITIAN DAN ANALISIS DATA............................................... 35

5.1 Hasil Penelitian ................................................................................................... 35

5.2 Analisis Data ....................................................................................................... 36

5.2.1 Uji Normalitas ............................................................................................... 36

5.2.3 Uji One-Way ANOVA .................................................................................. 37

5.2.4 Uji Post-hoc ................................................................................................. 38

5.2.5 Regresi Linear .............................................................................................. 39

BAB 6 PEMBAHASAN ................................................................................................ 40

BAB 7 KESIMPULAN DAN SARAN .......................................................................... 44

7.1 Kesimpulan ......................................................................................................... 44

7.2 Saran ................................................................................................................... 44

DAFTAR PUSTAKA .................................................................................................... 45

LAMPIRAN .................................................................................................................. 50

DAFTAR TABEL

Tabel Halaman

2.1. Kandungan Fitokima Rimpang Jahe Merah.................................................15

2.2. Aktivitas biologik senyawa dalam jahe…………………………………....16

4.1. Tabel Definisi Operasional ....................................................................... 24

4.2. Tabel Penentuan Dosis MDR-TB berdasarkan Kelompok Berat Badan ..... 29

4.3. Konversi Penghitungan Dosis .................................................................. 29

4.4. Tabel Jadwal Penelitian ............................................................................ 34

5.1. Tabel Data Hasil Penelitian ...................................................................... 35

5.2. Hasil Uji Saphiro Wilk ............................................................................. 36

5.3. Uji Levene Test ........................................................................................ 37

5.4. Hasil Uji One-way Anova ......................................................................... 37

5.5. Uji post hoc Bonferroni ............................................................................ 38

5.6. Regresi Linear .......................................................................................... 39

DAFTAR GAMBAR

Gambar Halaman

2.1. Tanaman Jahe Merah (Zingiber officinale Roscoe) .......................................... 13

2.2. Rimpang Jahe Merah (Zingiber officinale Roscoe)........................................... 14

2.3. Rattus norvegicus strain wistar ........................................................................ 17

3.1. Kerangka Konsep ............................................................................................ 18

DAFTAR SINGKATAN

APP : Acute Phase Protein.

CSF : Cerebrospinal Fluid.

DM : Diabetes Melitus

DNA : Deoxyribo Nucleic Acid.

DOTS : Directly Observed Treatment Short- course.

ELISA : Enzyme-Linked Immunosorbent Assay.

EMB : Etambutol

FDA : Food and Drug Agency

GF : Growth Factor.

IFN : Interferon.

IL-1 : Interleukin-1.

IL-6 : Interleukin-6.

INH : Isoniazid.

LFX : Levofloxacin

M : Metionin

MDR : Multi-Drug Resistant.

NK-CELL : Natural Killer Cell.

RIF : Rifampisin

OAT : Obat Anti Tuberkulosis.

PZA : Pirazinamid

STR : Streptomisin

TB : Tuberkulosis.

TB-MDR : Tuberculosis Multi-drug Resistant.

Th : T-helper.

TNF : Tumor Necrosis Factor.

WHO : World Health Organization.

DAFTAR LAMPIRAN

Lampiran Halaman

1. Dokumentasi ....................................................................................... 50

2. Hasil Pengamatan ................................................................................ 53

3. Hasil Analisis Statistik ......................................................................... 54

4. Surat Determinasi Buah Jahe ................................................................ 56

5. Surat Etik Penelitian ............................................................................ 57

6. Surat Keterangan Telah Melaksanakan Penelitian ................................ 58

7. Surat Keterangan Lolos Uji Plagiasi FK UMM ................................... 59

8. Surat Keterangan Lolos Komisi Ilmiah (Mears) .................................. 60

9. Lembar Bimbingan Konsultasi Tugas Akhir…………………………...61

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