hasil penelitian pengaruh pemberian ekstrak daun lidah...
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HASIL PENELITIAN
PENGARUH PEMBERIAN EKSTRAK DAUN LIDAH MERTUA (Sansevieria
trifasciata var. laurentii) TERHADAP DEGENERASI HIDROPIK PADA HEPAR
TIKUS (Rattus norvegicus strain wistar) YANG DIINDUKSI TIMBAL PER-ORAL
Oleh :
INTAN PERMATA BALQIS
201410330311075
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH MALANG
2018
HASIL PENELITIAN
PENGARUH PEMBERIAN EKSTRAK DAUN LIDAH MERTUA
(Sansevieria trifasciata var. laurentii) TERHADAP DEGENERASI
HIDROPIK PADA HEPAR TIKUS (Rattus norvegicus strain wistar)
YANG DIINDUKSI TIMBAL PER-ORAL
KARYA TULIS AKHIR
Diajukan kepada
Universitas Muhammadiyah Malang
Untuk Memenuhi Salah Satu Persyaratan
Dalam Menyelesaikan program Sarjana
Fakultas Kedokteran
Oleh :
INTAN PERMATA BALQIS
201410330311075
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH MALANG
2018
i
LEMBAR PENGESAHAN
LAPORAN HASIL PENELITIAN
Telah disetujui sebagai hasil penelitian
untuk memenuhi persyaratan
pendidikan sarjana Fakultas Kedokteran
Universitas Muhammadiyah Malang
Tanggal 21 Agustus 2018
Pembimbing I
dr. Desy Andari, M.Biomed
Pembimbing II
dr. Gita Sekar Prihanti,MPd.Ked
Mengetahui,
Fakultas Kedokteran Universitas Muhammadiyah Malang
Dekan,
Dr. dr. Meddy Setiawan, Sp.PD
ii
LEMBAR PENGUJIAN
Karya Tulis Akhir oleh Intan Permata Balqis ini
telah diuji dan di pertahankan di depan Tim Penguji
pada tanggal 21 Agustus 2018
Tim Penguji
dr. Desy Andari, M. Biomed , Ketua
dr. Gita Sekar Prihanti, MPd.Ked , Anggota
dr. Alfa Sylvestris Sp.M . , Anggota
iii
PERNYATAAN ORISINALITAS
Karya tulis akhir ini adalah karya saya sendiri, dan semua sumber baik yang
dikutip maupun dirujuk telah saya nyatakan dengan benar.
Nama : Intan Permata Balqis
NIM : 201410330311075
Malang,20 Agustus 2018
Intan Permata Balqis
iv
KATA PENGANTAR
Assalamu’alaikum Warahmatullahi Wabarakatuh
Puji dan syukur penulis panjatkan kehadirat Allah SWT yang telah
memberikan rahmat dan hidayatnya sehingga penulis dapat menyelesaikan hasil
penelitian berjudul “Pengaruh Pemberian Ekstrak Daun Lidah Mertua (Sansevieria
trifasciata var. laurentii) terhadap Degenerasi Hidropik pada Hepar Tikus (Rattus
norvegicus strain wistar) yang Diinduksi Timbal per-Oral”
Penulis mengucapkan terima kasih dan rasa syukur yang tak terhingga
kepada Allah SWT yang senantiasa membukakan jalan dan memberikan
kemudahan, kedua orang tua Penulis yang selalu mendukung Penulis dalam segala
keadaan, dosen pengajar Fakultas Kedokteran Universitas Muhammadiyah Malang
yang membekali Penulis dengan ilmu dan pengetahuan selama Penulis menempuh
pendidikan, serta teman-teman seperjuangan yang memotivasi dan menghibur
penulis hingga dapat menyelesaikan proposal penelitian ini.
Penulis berharap tulisan yang dibuat oleh penulis dapat memberikan
manfaat yang besar bagi pembaca dan Penulis mengharapkan kritik dan saran yang
membangun agar dapat menjadi lebih baik di masa yang akan datang.
Akhir kata, Wassalamu’alaikum Warahmatullahi Wabarakatuh
Malang, 20 Agustus 2018
Penulis
v
UCAPAN TERIMA KASIH
Penulis ingin menyampaikan terima kasih yang sebesar-besarnya kepada :
1. Dr. dr. Meddy Setiawan, Sp.PD, selaku Dekan Fakultas Kedokteran
Universitas Muhammadiyah Malang.
2. dr. Moch Ma’roef, Sp.OG selaku Pembantu Dekan I Fakultas Kedokteran
Universitas Muhammadiyah Malang.
3. dr. Sri Adilla Nurainiwati, Sp.KK, selaku Pembantu Dekan II Fakultas
Kedokteran Universitas Muhammadiyah Malang.
4. dr. Indra Setiawan, Sp.THT-KL, selaku Pembantu Dekan III Fakultas
Kedokteran Universitas Muhammadiyah Malang.
5. dr.Desy Andari, M.Biomed, selaku pembimbing 1 Fakultas Kedokteran
Universitas Muhammadiyah Malang.
6. dr.Gita Sekar Prihanti, MPd.Ked, selaku pembimbing 2 Fakultas Kedokteran
Universitas Muhammadiyah Malang.
7. dr. Alfa Sylvestris Sp.M selaku penguji Fakultas Kedokteran Universitas
Muhammadiyah Malang.
8. dr. Anung Putri Ilaihika, MKes dan dr. Irma Nur Sukmawati sebagai
pembimbing Mears
9. Kedua orang tua saya, Bapak Ifzal dan Ibu Masitah yang telah memberikan
kasih sayang, dukungan moral dan materi, perhatian serta doanya selama
saya menempuh pendidikan.
10. Kakak dan adik yang saya sayangi M.Fajrin Hidayah, Mutiara Balqis dan
Berlian Putri Balqis yang telah memberikan dukungan, semangat dan doanya
untuk kelancaran tugas akhir ini.
vi
11. Sahabat-sahabat anggota geng colo, yaitu Bonanza Vidya Rashmi Nugroho,
Alfiani Rahmi Mukti, Sabrina Annisa, beserta Amira yang merupakan teman
seperjuangan yang terus mendukung dan ada disaat susah dan senang selama
menempuh pendidikan di FK UMM
12. Sahabat-sahabat yang tidak pernah bosan menemani saya sejak SMP hingga
menyelesaikan tugas akhir ini, Ayu Dwi Rahmawati, Ayu Indriyani Yusup,
Tiwi Pangesti, dan Ummul Humairah.
13. Sahabat-sahabat yang tidak bisa saya lupakan kehadirannya M.Raka
Cahyoadi, Barnard M.Syaifudin, Nejoa Ermaq Fetriciano, Hasan Assegaf,
dan Riswanda Imawan.
14. Seluruh teman-teman “Medula Spinalis” angkatan 2014 FK UMM yang tidak
bisa disebutkan satu persatu. Terimakasih atas segala bantuan, motivasi, doa
selama perkuliahan.
15. Staf Mears Mbak Deva dan Mas Idul yang telah membantu untuk belajar
statistik dan penggunaan SPSS 23.
16. Staf TU, Bu Endah, Mbak Nuke, Mbak citra, Pak yon, Mas Joko, Mas Didit,
yang telah membantu administrasi penulis dalam menyelesaikan TA.
17. Staf Biomedik, Bu Fat, Pak Joko, Mas Nyono, Mas Miftah, Pak Kus yang
telah membantu administrasi penulis dalam menyelesaikan TA
18. Para dosen pengajar FK UMM yang telah memberikan bekal ilmu dan
pengetahuan.
19. 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.
vii
ABSTRAK
Balqis, Intan Permata. 2018. Pengaruh Pemberian Ekstrak Daun Lidah Mertua (Sansevieria trifasciata laurentii) terhadap Degenerasi Hidropik Hepar Tikus (Rattus novergicus strain wistar) yang Diinduksi Timbal Per-Oral. Tugas Akhir. Fakultas Kedokteran Universitas Muhammadiyah Malang. Pembimbing: (I) Desy Andari* (II) Gita Sekar Prihanti.**
Latar belakang: Kerusakan hepar dapat terjadi pada semua orang. Peningkatan ROS akibat timbal dapat memicu kerusakan hepar,dan degenerasi hidropik merupakan tanda awal kerusakan hepar. Lidah mertua dengan kandungan vitamin C,leucine,glutamate, dan flavonoid diduga menghambat efek radikal bebas timbal. Tujuan : Mengetahui pengaruh ekstrak daun lidah mertua terhadap degenerasi hidropik hepar tikus yang diinduksi timbal per-oral. Metode Penelitian : True Experimental dengan Post Test Only Control Group Design. 20 tikus dibagi 4 kelompok perlakuan, K+ diinduksi timbal 26mg/200grBB/hari, P1; P2; P3 diinduksi timbal dan ekstrak lidah mertua 20; 40; 80 (mg/200grbb/hari). Hepar tikus dibuat sediaan H&E dan diamati dengan mikroskop Hasil Penelitian dan Pembahasan : Hasil Uji One-way ANOVA didapatkan perbedaan bermakna (p=0,003), uji Post-Hoc Bonferroni terdapat perbedaan bermakna antara grup kontrol dan kelompok dosis 80mg/grBB/hari ekstrak daun lidah mertua (p=0,003). Hasil uji regresi linier didapatkan AR Square : 0,581 (ekstrak daun lidah mertua memberikan pengaruh 58,1% pada degenerasi hidropik.). Penurunan degenerasi hidropik disebabkan kandungan vitamin C, leucine,glutamate,dan flavonoid yang menghambat radikal bebas. Kesimpulan : Ekstrak daun lidah mertua memiliki pengaruh dalam menurunkan jumlah degenerasi hidropik hepar tikus. Kata Kunci :Timbal, hepar, degenerasi hidropik,ekstrak daun lidah mertua, vitamin C,leucine, glutamate, dan flavonoid
*) Staf Pengajar Bidang Histologi Fakultas Kedokteran Universitas Muhammadiyah Malang **) Staf Pengajar Bidang Ilmu Kesehatan Masyarakat Fakultas Kedokteran Universitas Muhammadiyah Malang
viii
ABSTRACT
Balqis, Intan Permata. 2018.The Effect of Snake Plant (Sansevieria trifasciata var.laurentii) Extract Towards the Amount of Hydropic Degeneration in Oral Lead-Induced White Rats (Rattus novergicus strain wistar) Liver. Bachelor Thesis. Medical Faculty of University of Muhammadiyah Malang. Advisor: (I) Desy Andari* (II) Gita Sekar Prihanti.**
Background : Liver injuries could happen to everyone. Increasing of ROS by lead can cause liver injuries and hydropic degeneration is an early sign of liver injuries. Snake plant contains vitamin C,leucine, glutamate, and flavonoid that expected to inhibit the free radicals effects caused by lead. Objective : To find the effect of Snake Plant extract towards the amount of hydropic degeneration in oral lead-induced white rats liver Methods:True experimental with post test only control group design, 20 rats were divided to 4 groups, K+ was given 26mg/200grBW/day lead induction, P1;P2;P3 was given lead induction and 20;40;80 (mg/200grBW/day) of Snake Plant extract, then rats liver were prepared with H&E stain and observed with microscope. Results and Discussion:One-way ANOVA test showed significant difference (p=0,003), Post-Hoc Bonferroni showed significant difference between control group and group with 80 mg/grBW/day of Snake Plant extract (p=0,003), linear regression test obtained AR Square : 0,581 (the Snake Plant extract had 58,1 % effect on hydropic degeneration). The decreasing of hydropic degeneration was caused by vitamin C, leucine, glutamate, and flavonoid that inhibited free radicals. Conclusion: Snake Plant extract had an effect on decreasing the amount of hydropic degeneration in white rats. Key Words: Lead, liver, hydropic degeneration, Snake Plant extract, vitamin C, leucine, glutamate, and flavonoid.
*)Lecturer of Histology, Medical Faculty, University of Muhammadiyah Malang. **)Lecturer of Public Health, Medical Faculty, University of Muhammadiyah Malang.
ix
DAFTAR ISI
LEMBAR PENGESAHAN ............................................................................. i
LAPORAN HASIL PENELITIAN ................................................................ i
LEMBAR PENGUJIAN ................................................................................. ii
PERNYATAAN ORISINALITAS ............................................................... iii
KATA PENGANTAR .................................................................................... iv
UCAPAN TERIMA KASIH ...........................................................................v
ABSTRAK ..................................................................................................... vii
DAFTAR ISI .................................................................................................. ix
DAFTAR TABEL ......................................................................................... xii
DAFTAR GAMBAR .................................................................................... xiii
DAFTAR SINGKATAN .............................................................................. xiv
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 ............................................................................4
1.4.1 Manfaat Akademis .........................................................................4
1.4.2 Manfaat Klinis ................................................................................4
1.4.3 Manfaat Masyarakat .......................................................................5
TINJAUAN PUSTAKA ...................................................................6
2.1. Hepar ................................................................................................6
2.1.1 Anatomi Hepar ...............................................................................6
2.1.2 Histologi Hepar ..............................................................................7
2.1.3 Fungsi hepar .................................................................................13
x
2.2. Timbal .............................................................................................17
2.2.1. Sumber Pencemaran Timbal ........................................................17
2.2.2. Toksisitas timbal ..........................................................................19
2.2.3. Mekanisme Keracunan Timbal ....................................................20
2.2.4. Klasifikasi antioksidan .................................................................24
2.3. Tanaman Lidah Mertua (Sansevieria trifasciata var. laurentii) .....25
2.3.1. Taksonomi Lidah Mertua .............................................................26
2.3.2. Anatomi dan Morfologi Lidah Mertua .........................................26
2.3.3. Habitat Tanaman Lidah Mertua ...................................................28
2.3.4. Kandungan Kimiawi Tanaman Lidah Mertua..............................28
2.4. Asam Amino ...................................................................................33
2.4.1. Leusin ...........................................................................................33
2.4.2. Glutamat .......................................................................................34
2.5. Vitamin C .......................................................................................35
2.5.1. Sumber Vitamin C dan Kebutuhan Manusia terhadap Vitamin C ......................................................................................................36
2.5.2. Vitamin C sebagai antioksidan.....................................................37
2.6. Tikus Putih ......................................................................................38
2.6.1. Taksonomi Tikus Putih ................................................................38
2.6.2. Anatomi dan fisiologi hepar tikus ................................................39
2.6.3. Histologi Hepar Tikus ..................................................................40
KERANGKA KONSEPTUAL DAN HIPOTESIS .....................42
3.1. Kerangka Konseptual Penelitian ....................................................42
3.2. Hipotesis .........................................................................................45
METODE PENELITIAN ..............................................................46
4.1 Jenis Penelitian ...............................................................................46
4.2 Tempat Dan Waktu Penelitian ........................................................46
4.3 Populasi Dan Sampel ......................................................................46
4.3.1 Populasi ........................................................................................46
4.3.2 Sampel ..........................................................................................46
4.3.3 Besar Sampel ................................................................................46
4.3.4 Teknik Pengambilan Sampel........................................................48
xi
4.3.5 Variabel Penelitian .......................................................................48
4.3.6 Definisi Operasional Variabel ......................................................49
4.4 Alat Dan Bahan Penelitian .............................................................50
4.4.1 Alat ...............................................................................................50
4.4.2 Bahan............................................................................................50
4.5 Dasar Penentuan Dosis ...................................................................51
4.5.1 Dosis Timbal ................................................................................51
4.5.2 Dosis Ekstrak Lidah Mertua (Sansevieria trifasciata var. laurentii) ......................................................................................................51
4.6 Prosedur Penelitian .........................................................................52
4.6.1 Proses Adaptasi ............................................................................52
4.6.2 Pembagian Kelompok Dan Perlakuan Tikus ...............................52
4.6.3 Pembuatan Ekstrak Daun Lidah Mertua ......................................53
4.6.4 Pembuatan Larutan Timbal Asetat (Pb(CH3COO)2)....................54
4.6.5 Pembedahan Tikus Dan Pengambilan Sampel Organ ..................54
4.6.6 Pembuatan Preparat Histologi ......................................................56
4.7 Alur Penelitian ................................................................................59
4.8 Analisis Data ..................................................................................60
4.9 Jadwal Penelitian ............................................................................61
HASIL PENELITIAN DAN ANALISIS DATA .........................62
5.1 Hasil Penelitian ...............................................................................62
5.2 Analisis Data ..................................................................................64
5.2.1 Uji One-way ANOVA..................................................................64
5.2.2 Uji Post-hoc Bonferroni ...............................................................65
5.2.3 Uji Regresi Linear ........................................................................65
PEMBAHASAN .............................................................................67
KESIMPULAN DAN SARAN ......................................................74
7.1 Kesimpulan .....................................................................................74
7.2 Saran ...............................................................................................74
DAFTAR PUSTAKA .....................................................................................76
LAMPIRAN ...................................................................................................83
xii
DAFTAR TABEL
Tabel 2.1 Batas Maksimum Timbal dalam Makanan ......................................18
Tabel 2.2 Komposisi nutrisi daun lidah mertua ...............................................29
Tabel 2.3 Profil asam amino tanaman lidah mertua ........................................30
Tabel 2.4 Profil vitamin tanaman lidah mertua ...............................................31
Tabel 2.5 Profil fitokimia tanaman lidah mertua .............................................32
Tabel 2.6 Komponen bioaktif tanaman yang terekstrak oleh pelarut yang
berbeda .............................................................................................................32
Tabel 2.7 Data fisiologis tikus putih ................................................................39
Tabel 2.8 Perbandingan pembagian segmen hepar manusia dengan tikus ......40
Tabel 4.1 Definisi operasional variabel ...........................................................49
Tabel 5.1 Hasil rata-rata jumlah degenerasi hidropik sel hepar tikus ..............63
Tabel 5.2 Hasil Uji Post-hoc Bonferroni .........................................................65
Tabel 5.3 Hasil Uji Regresi Linear ..................................................................65
xiii
DAFTAR GAMBAR
Gambar 2.1 Anatomi Hepar ...............................................................................7
Gambar 2.2 Struktur umum organ hepar ..........................................................8
Gambar 2.3 Struktur umum organ hepar ...........................................................8
Gambar 2.4 Histologi umum hepar. .................................................................10
Gambar 2.5 Gambaran hepar pada tikus yang diberikan larutan timbal dalam
durasi pendek ...................................................................................................23
Gambar 2.6 Gambaran pada hepar tikus yang diberikan timbal dalam durasi
panjang .............................................................................................................23
Gambar 2.7 Tanaman Sansevieria trifasciata var. laurentii ............................25
Gambar 2.8 Struktur kimia asam amino leusin ................................................34
Gambar 2.9 Struktur kimia asam amino glutamat ...........................................35
Gambar 2.10 Struktur kimia vitamin C ...........................................................36
Gambar 2.11 Perbandingan segmen hepar tikus dengan manusia ...................40
Gambar 2.12 A : Gambaran struktur hepar tikus normal ................................41
Gambar 4.1 Alur Penelitian .............................................................................59
Gambar 5.1 Kontrol positif, P1, P2, dan P3, ...................................................63
Gambar 5.2 Grafik Rata-Rata Jumlah Degenerasi Hidropik pada Sel Hepatosit
Hepar Tikus ......................................................................................................64
xiv
DAFTAR SINGKATAN
ALA : 5-Aminolevulinic Acid
ALAD : Delta-aminolevulinic Acid Dehydratase
ALP : Alkaline Phosphatase
ALT : Alanine Transaminase
AST : Aspartate Aminotransferase
CAT :Catalase
CCl4 :Carbon Tetrachloride
GH :Growth Hormone
GHRH :Growth Hormone Releasing Hormone
GPX :Gluthathione Peroxidase
GR :Gluthathione Reductase
GSH :Gluthathione
GSSG :Gluthathione Disulfide
HDL :High Density Lipoprotein
IL-1β : Interleukin 1 Beta
IL-6 :Interleukin 6
IL-8 :Interleukin 8
LDL :Low Density Lipoprotein
PBG :Porphobilinogen
PUFA :Polyunsaturated Fatty Acid
RBP :Retinol Binding Protein
ROS : Reactive Oxygen Species
SOD :Superoxide Dismutase
TNF-ɑ :Tumor Necrosis Factor Alpha
UV :Ultra Violet
VLDLs :Very Low Density Lipoprotein
DMSA :Di-Mercapto Succinic Acid
RNS :Reactive Nitrogen Species
76
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