KARYA TULIS AKHIR

PENGARUH EKSTRAK DAUN GINSENG JAWA (Talinum triangulare)

TERHADAP HISTOPATOLOGI HEPAR TIKUS JANTAN (Rattus

norvegicus strain wistar) YANG DIBERI DIET KOLESTEROL TINGGI

Oleh:

TRI NURDIANI

201310330311150

FAKULTAS KEDOKTERAN

UNIVERSITAS MUHAMMADIYAH MALANG

2017

HASIL PENELITIAN

PENGARUH EKSTRAK DAUN GINSENG JAWA (Talinum triangulare)

TERHADAP HISTOPATOLOGI HEPAR TIKUS PUTIH JANTAN (Rattus

norvegicus strain wistar) YANG DIBERI DIET KOLESTEROL TINGGI

KARYA TULIS AKHIR

Diajukan kepada

Universitas Muhammadiyah Malang

untuk Memenuhi Salah Satu Persyaratan

dalam Menyelesaikan Program Sarjana

Fakultas Kedokteran

Oleh:

TRI NURDIANI

201310330311150

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2017

LEMBAR PENGESAHAN

LAPORAN HASIL PENELITIAN

Telah disetujui sebagai hasil penelitian untuk memenuhi persyaratan

Pendidikan Sarjana Fakultas Kedokteran Universitas Muhammadiyah Malang

Tanggal : Januari 2017

Pembimbing I

dr. Desy Andari, M.Biomed

Pembimbing II

dr. Thontowi Djauhari NS., M.Kes

Mengetahui, Dekan Fakultas Kedokteran

Universitas Muhammadiyah Malang

dr. Irma Suswati, M.Kes

KATA PENGANTAR

Alhamdulillah, dengan memanjatkan puji dan syukur kehadirat Tuhan Yang Maha

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

Judul “Pengaruh Ekstrak Daun Ginseng Jawa (Talinum Triangulare) Terhadap

Histopatologi Hepar Tikus Putih Jantan (Rattus Norvegicus Strain Wistar) Yang

Diberi Diet Kolesterol Tinggi” dapat terselesaikan dengan baik. Begitu pula

Dialah yang menyelaraskan gerakan tangan dan pikiran dalam merangkai huruf

menjadi kata dan selanjutnya menjadi kalimat dalam penulisan tugas akhir ini.

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 penelitian 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, Januari 2017

Penulis

UCAPAN TERIMA KASIH

1. Ibunda Hariyati dan Ayahanda Nurdin Lasupu selaku orangtua penulis

yang telah memberikan dorongan dan motivasi serta kasih sayang,

sehingga penulis bisa menyelesaikan karya tulis ini.

2. dr. Desy Andari, M.Biomed selaku pembimbing I atas segala dukungan,

masukan dan saran yang sangat luar biasa dalam penyusunan karya tulis

ini.

3. dr. Thontowi Djauhari NS., M.Kes selaku pembimbing II atas segala

bimbingan dan koreksi serta motivasi yang diberikan demi kesempurnaan

karya tulis ini

4. dr. Gita Sekar Prihanti, M.Pd. Ked selaku dosen penguji yang telah

meluangkan waktu untuk menguji dan memberikan banyak masukan untuk

menyelesaikan tugas akhir ini.

5. dr. Irma Suswati selaku dekan Fakultas kedokteran Universitas

Muhammadiyah Malang.

6. Seluruh staf tata usaha Fakultas kedokteran Universitas Muhammadiyah

Malang atas segala dukungan yang telah diberikan.

7. Sahabat penulis, Muhammad Aril Putra, Diandra, Bunga, Nabila, Firda,

Febby, Chika, Ganda, dan Gagas yang telah banyak membantu dan

memberikan motivasi serta doanya dalam penyusunan laporan penelitian

ini.

8. Sejawat kelompok penelitian Rika, Daus, Tiara, Hendrian, dan Ricky yang

telah banyak membantu dalam masa penelitian dan memberi motivasi

dalam penyusunan laporan ini

9. Segenap keluarga besar Asisten Dosen Patologi Klinik Fakultas

Kedokteran Universitas Muhammadiyah Malang, dr. Sulistyo Mulyo

Agustini, Sp. PK, dr. Diah Hermayanti, Sp. PK, Mas Nyono, Bu Pat,

Ajeng, Baiq, Memey, Apri, kakak-kakak dan adik-adik, yang telah

memberikan kesempatan untuk belajar bersama dan berbagi ilmu.

10. Seluruh teman-teman angkatan 2013 yang tidak bisa disebutkan satu

persatu. Terimakasih atas segala bantuan, motivasi, doa selama

perkuliahan. Semoga kita semua menjadi dokter yang bermaanfaat bagi

agama, bangsa, dan negara. Aamiin.

11. Semua pihak yang tidak dapat disebutkan namanya satu persatu, yang

telah memeberikan dukungan dan motivasi dalam penyeleseaian laporan

penelitian ini.

DAFTAR ISI HALAMAN JUDUL .................................................................................. i LEMBAR PENGESAHAN ....................................................................... ii LEMBAR PENGUJIAN .......................................................................... iii PERNYATAAN ORISINALITAS .......................................................... iv KATA PENGANTAR .............................................................................. v ABSTRAK .............................................................................................. viii ABSTRACT............................................................................................... ix DAFTAR ISI ............................................................................................. x DAFTAR TABEL .................................................................................. xiii DAFTAR GAMBAR .............................................................................. xiv DAFTAR SINGKATAN ......................................................................... xv DAFTAR LAMPIRAN .......................................................................... xvi BAB I PENDAHULUAN .......................................................................... 1

1.1 Latar Belakang .............................................................................. 1 1.2 Rumusan Masalah ......................................................................... 3 1.3 Tujuan Penelitian .......................................................................... 3

1.3.1 Tujuan Umum ...................................................................... 3 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 ............................................................. 4

BAB II TINJAUAN PUSTAKA ............................................................... 5 2.1 Daun Ginseng Jawa ....................................................................... 5

2.1.1 Taksonomi Ginseng Jawa ..................................................... 5 2.1.2 Morfologi Daun Ginseng Jawa ............................................. 5 2.1.3 Habitat dan Distribusi Tanaman Ginseng Jawa ..................... 6 2.1.4 Penggunaan Daun Ginseng Jawa .......................................... 6 2.1.5 Kandungan Daun Ginseng Jawa............................................ 7

2.2 Hepar Manusia .............................................................................. 7 2.2.1 Anatomi................................................................................ 7 2.2.2 Histologi ............................................................................... 9 2.2.3 Fisiologi ............................................................................. 10

2.3 Tikus(Rattus norvegicus) ............................................................. 11 2.3.1 Hepar Tikus ........................................................................ 12

2.3.1.1 Anatomi dan fisiologi .................................................. 12 2.3.1.2 Histologi ..................................................................... 14

2.4 Metabolisme Lemak .................................................................... 16 2.5 Perlemakan Hati Non Alkoholik .................................................. 18

2.5.1 Definisi............................................................................... 18 2.5.2 Patogenesis ......................................................................... 19 2.5.3 Faktor Resiko ..................................................................... 20 2.5.4 Tanda dan Gejala ................................................................ 21 2.5.5 Gambaran Histopatologis.................................................... 22

2.6 Dislipidemia ................................................................................ 25 2.6.1 Definisi............................................................................... 25

2.6.2 Komposisi Lipoprotein ....................................................... 26 2.6.3 Klasifikasi Kadar Lipid Plasma ........................................... 26 2.6.4 Dislipidemia dan Pengaruhnya pada NAFLD...................... 27

2.7 Radikal Bebas ............................................................................. 27 2.8 Stes Oksidatif .............................................................................. 28

2.8.1 Peroksidasi Lipid ................................................................ 28 2.8.2 Kerusakan Protein .............................................................. 28 2.8.3 Kerusakan DNA ................................................................. 29

2.9 Antioksidan .................................................................................. 29 2.9.1 Mekanisme Kerja Antioksidan ............................................ 30 2.9.1.1 Peran Antioksidan Enzimatik ........................................... 30 2.9.1.2 Peran Antioksidan Non Enzimatik ................................... 31

BAB III KERANGKA KONSEP DAN HIPOTESIS............................. 35 3.1 Kerangka Konsep ........................................................................ 35 3.2 Hipotesis ..................................................................................... 37

BAB IV METODE PENELITIAN ......................................................... 38 4.1 Rancangan Penelitian .................................................................. 38 4.2 Tempat dan Waktu Penelitian ...................................................... 38 4.3 Populasi dan Sampel ................................................................... 38

4.3.1 Populasi .............................................................................. 38 4.3.2 Sampel ............................................................................... 38 4.3.3 Besar Replikasi ................................................................... 38 4.3.4 Teknik Pengambilan Sampel............................................... 40 4.3.4 Karakteristik Sampel Penelitian .......................................... 40

4.4 Variabel dan Definisi Operasional ............................................... 40 4.4.1 Variabel .............................................................................. 40 4.4.2 Definisi Operasional ........................................................... 41

4.5 Bahan dan Instrumen ................................................................... 42 4.5.1 Bahan ................................................................................. 42 4.5.2 Instrumen ........................................................................... 42

4.6 Alur Penelitian ............................................................................ 44 4.7 Prosedur Penelitian ...................................................................... 45

4.7.1 Pembagian Kelompok Tikus ............................................... 45 4.7.2 Adaptasi ............................................................................. 46 4.7.3 Penentuan Dosis Ekstrak Daun Ginseng Jawa ..................... 46 4.7.4 Pemberian Diet Kolesterol Tinggi ....................................... 47 4.7.5 Pembuatan Ekstrak Daun Ginseng Jawa ............................. 48 4.7.6 Proses Anestesi dan Pembedahan Hewan Coba .................. 49 4.7.7 Perlakuan Terhadap Hewan Coba Setelah Dibedah ............. 49 4.7.8 Pembuatan Sediaan Histologi ............................................. 49 4.7.9 Pengamatan Hasil ............................................................... 51 4.7.9 Analisis Data ...................................................................... 51

BAB V HASIL PENELITIAN DAN ANALISIS DATA ....................... 53 5.1 Hasil Penelitian .......................................................................... 53 5.2 Analisis Data.............................................................................. 55 BAB VI PEMBAHASAN ........................................................................ 57

BAB VII KESIMPULAN DAN SARAN ................................................ 61 7.1 Kesimpulan ................................................................................ 61 7.2 Saran .......................................................................................... 61 LAMPIRAN ............................................................................................ 62 DAFTAR PUSTAKA .............................................................................. 76

DAFTAR LAMPIRAN

LAMPIRAN HALAMAN

Lampiran 1 Hasil Pengamatan.............................................................................62

Lampiran 2 Analisis Data....................................................................................63

Lampiran 3 Dokumentasi.....................................................................................69

Lampiran 4 Surat Keterangan Kelayakan Etik....................................................70

Lampiran 5 Surat Determinasi Tanaman Ginseng Jawa......................................71

Lampiran 6 Surat Keterangan Penelitian.............................................................72

Lampiran 7 Surat Keterangan Pembacaan Histopa.............................................73

Lampiran 8 kartu konsultasi.................................................................................74

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