ANINA NI’MATUL JANNAHeprints.umm.ac.id/47026/1/PENDAHULUAN.pdf · 2019-07-15 · KARYA TULIS...
Transcript of ANINA NI’MATUL JANNAHeprints.umm.ac.id/47026/1/PENDAHULUAN.pdf · 2019-07-15 · KARYA TULIS...
KARYA TULIS AKHIR
PENGARUH EKSTRAK BUAH MENGKUDU (Morinda citrifolia)
TERHADAP DIAMETER SEL LANGERHANS TIKUS PUTIH (Rattus
novergicus strain wistar) YANG DI INDUKSI STREPTOZOTOCIN
DISUSUN OLEH :
ANINA NI’MATUL JANNAH
201510330311088
UNIVERSITAS MUHAMMADIYAH MALANG
FAKULTAS KEDOKTERAN
2019
xii
DAFTAR ISI
LEMBAR PENGESAHAN .................................................................................. iii
PERNYATAAN ORISINALITAS ....................................................................... iv
LEMBAR PENGUJIAN ....................................................................................... v
KATA PENGANTAR ........................................................................................... vi
UCAPAN TERIMAKASIH.................................................................................. vii
ABSTRAK ............................................................................................................ x
ABSTRACT ........................................................................................................... xi
DAFTAR ISI .......................................................................................................... xii
DAFTAR TABEL ................................................................................................. xvi
DAFTAR GAMBAR ............................................................................................. xvii
DAFTAR SINGKATAN ....................................................................................... xviii
BAB 1 ...................................................................................................................... 1
PENDAHULUAN .................................................................................................. 1
1.1 Latar Belakang .......................................................................................... 1
1.2 Rumusan Masalah ..................................................................................... 4
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 Ilmu Pengetahuan .............................................................. 4
1.4.2 Manfaat Klinis ................................................................................. 5
1.4.3 Manfaat bagi Masyarakat ................................................................ 5
BAB 2 ....................................................................................................................... 6
TINJAUAN PUSTAKA ........................................................................................ 6
2.1 Mengkudu .................................................................................................. 6
2.1.1 Taksonomi ....................................................................................... 6
2.1.2 Definisi ............................................................................................. 7
2.1.3 Morfologi ......................................................................................... 7
2.1.4 Kandungan Buah Mengkudu (Morinda citrifolia) ........................... 8
2.2 Hiperglikemia ............................................................................................ 12
2.2.1 Definisi ............................................................................................. 12
2.2.2 Etiologi .............................................................................................. 12
xiii
2.2.3 Mekanisme stress oksidatif pada hiperglikemia ............................... 13
2.3 Diabetes Melitus ........................................................................................ 14
2.3.1 Definisi .............................................................................................. 14
2.3.2 Klasifikasi Diabetes Melitus ............................................................. 14
2.3.3 Pathogenesis Diabetes Melitus ......................................................... 16
2.3.4 Diagnosis Diabetes Melitus .............................................................. 17
2.3.5 Komplikasi Diabetes Melitus ............................................................ 20
2.4 Pankreas dan Hormon Insulin ................................................................. 21
2.4.1 Organ Pankreas ................................................................................. 21
2.4.2 Hormon Insulin ................................................................................. 23
2.4.3 Mekanisme Produksi Insulin ............................................................ 24
2.5 Streptozotocin (STZ) ................................................................................ 25
2.5.1 Definisi ............................................................................................... 25
2.5.2 Mekanisme STZ Dalam Memicu Diabetes ........................................ 25
2.5.3 Perbedaan Dengan Alloksan .............................................................. 26
BAB 3 ..................................................................................................................... 30
KERANGKA KONSEPTUAL DAN HIPOTESIS PENELITIAN .................. 30
3.1 Kerangka Konseptual Penelitian ................................................................ 30
3.2 Hipotesis ..................................................................................................... 32
BAB 4 ..................................................................................................................... 33
METODOLOGI PENELITIAN .......................................................................... 33
4.1 Jenis Penelitian ........................................................................................... 33
4.2 Lokasi Penelitian ........................................................................................ 33
4.3 Sampel dan Replikasi ................................................................................. 33
4.3.1 Sampel .............................................................................................. 33
4.3.2 Replikasi ........................................................................................... 33
4.3.3 Estimasi Besar Sampel ...................................................................... 33
4.3.4 Karakteristik Sampel Penelitian ........................................................ 35
4.4 Variabel Penelitian ..................................................................................... 35
4.4.1 Variabel Bebas .................................................................................. 35
4.4.2 Variabel Tergantung ......................................................................... 35
4.4.3 Variabel Kontrol ............................................................................... 36
4.5 Definisi Operasional .................................................................................... 36
4.6 Alat dan Bahan Penelitian ........................................................................... 37
4.5.1 Alat ..................................................................................................... 37
4.5.2 Bahan ................................................................................................. 38
4.7 Alur Penelitian ............................................................................................. 39
4.8 Prosedur Penelitian ..................................................................................... 40
4.8.1 Adaptasi Hewan Percobaan .............................................................. 40
xiv
4.8.2 Pengelompokan Tikus ....................................................................... 40
4.8.3 Penentuan Dosis ................................................................................ 40
4.8.4 Pembuatan Larutan Streptozotocin ................................................... 41
4.8.5 Pembuatan Larutan Ekstrak Mengkudu ............................................ 41
4.8.6 Percobaan .......................................................................................... 42
4.9 Analisis Data ............................................................................................... 46
4.9.1 Uji Normalitas .................................................................................... 46
4.9.2 Uji Homogenitas ................................................................................ 47
4.9.3 Uji ANOVA dan Post Hoc Bonferroni .............................................. 47
4.9.4 Uji Regresi Linier ............................................................................... 47
BAB 5 .................................................................................................................... 48
HASIL PENELITIAN DAN ANALISIS DATA ................................................ 48
5.1 Hasil Penelitian ........................................................................................... 48
5.2 Analisis Data ............................................................................................... 50
5.2.1 Uji One Way ANOVA ....................................................................... 50
5.2.2 Uji Post Hoc Bonferroni..................................................................... 50
5.2.3 Uji Regresi Linier ............................................................................... 51
BAB 6 ..................................................................................................................... 54
PEMBAHASAN .................................................................................................... 54
BAB 7 ..................................................................................................................... 60
KESIMPULAN DAN SARAN ............................................................................. 60
7.1 Kesimpulan ................................................................................................. 60
7.2 Saran ............................................................................................................ 60
DAFTAR PUSTAKA ............................................................................................ 61
LAMPIRAN ........................................................................................................... 70
I. Analisis Data ............................................................................................... 70
II. Dokumentasi Kegiatan ................................................................................ 72
III. Uji Taksonomi Buah Mengkudu ................................................................. 75
IV. Surat Etik Penelitian .................................................................................... 76
V. Surat Keterangan Lolos Komisi Ilmiah ....................................................... 77
VI. Surat Pembacaan Hasil Patologi Anatomi .................................................. 78
VII. Surat Keterangan Telah Melakukan Penelitian ..................................... 79
VIII. Kartu Konsultasi Tugas Akhir .............................................................. 80
IX. Hasil Deteksi Plagiasi ........................................................................... 82
61
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DAFTAR TABEL
Halaman
2.1.4 Hasil Skrining Fitokimia Ekstrak Buah Mengkudu ................................... 9
2.1.4 Tingkat antioksidan dalam ekstrak buah sirsak .........................................10
2.1.4 Daftar Penelitian Efek Kandungan Buah Mengkudu Terhadap Diabetes
Mellitus ...................................................................................................... 10
2.3.4 Diagnosis Diabetes Mellitus ...................................................................... 19
2.3.4 Kategori Status Glukosa ............................................................................. 20
2.5.3. Perbandingan sifat kimia Alloxan dan Streptozotocin............................ 27
5.1 Rata – rata diameter sel Langerhans............................................................. 46
5.2 Hasil Analisis One-Way ANOVA................................................................ 48
5.3 Hasil Analisis Post Hoc Bonferroni.............................................................. 49
5.4 Hasil Analisis Regresi Linier........................................................................ 49
xvii
DAFTAR GAMBAR
Halaman
2.1.1 Tumbuhan Mengkudu .................................................................................. 6
2.1.4 Fitokimia Morinda citrifolia .........................................................................9
2.4.1 Bentuk Anatomi Pankreas. ......................................................................... 21
2.4.1 Bentuk Histologi Pankreas Normal ............................................................ 22
2.4.1 Diameter Langerhans Tikus ....................................................................... 23
2.4.2 Struktur Hormon Insulin ............................................................................ 23
2.5.3. Representasi skematis efek toksik dari analog glukosa aloksan dan
Streptozotocin dalam sel beta.....................................................................28
5.1 Gambar Diameter Sel Langerhans................................................................ 47
5.2 Grafik Antara Diameter Sel Langerhans dengan Pemberian Dosis Ekstrak...51
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DAFTAR SINGKATAN
ADA : American Diabetes Association
ADP : Adenosin Diphosphate
AGEs : Advanced Glycation EndProducts
ATP : Adenosin Triphosphate
cAMP : Cyclic Adenosine Monophosphate
DM : Diabetes Mellitus
DMG : Diabetes Melitus Gestasional
DNA : Deoxyribonucleic Acid
eNOS : Endothelial Nitric Oxide Synthase
GAD : Glutamic Acid Decarboxylase
GDP : Gula Darah Puasa
GDS : Gula Darah Sewaktu
GH : Growth Hormone
GHRH : Growth Hormone Releasing Hormone
GIP : Glucose Dependent Insulinotropic Polypeptide
GLP : Glucagon Like Peptide
GLUT : Glucose Transporter
HDL : High-density lipoprotein
HE : Hematoxycilin Eosin
IDDM : Insulin Dependent Diabetes Mellitus
IDF : International Diabetes Federation
IGF : Insulin-Like Growth Factor
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IP : Intraperitoneal
ISPAD : International Society for Pediatrics and Adolescent
Diabetes
KGD : Kadar Gula Darah
MDA : Malondialdehyde
NAD+ : Nicotinamide Adenine Dinucleotide
NFκB : Nuclear Factor Kappa B
NIDDM : Non Insulin Dependent Diabetes Mellitus
NO : Nitric Oxide
RAGE : ReceptorAdvanced Glycation EndProducts
RISKESDAS : Riset Kesehatan Dasar
ROS : Reactive Oxygen Species
SOD : Superoxide Dismutase
STZ : Streptozotocin
TNF-α : Tumor Necrosis Factor - Α
TTGO : Test Toleransi Glukosa Oral
VEGF : Vascular Endothelial Growth Factor
WHO : World Health Organization
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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 Buah Mengkudu
(Morinda citrifolia) Terhadap Diameter Sel Langerhans Tikus Putih (Rattus
novergicus strain wistar) Yang Di Induksi Streptozotocin”. 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, 14 Mei 2019
Penulis
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