KARYA TULIS AKHIR PENGARUH EKSTRAK BUAH MENGKUDU karya tulis akhir pengaruh ekstrak buah mengkudu (morinda

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  • KARYA TULIS AKHIR

    PENGARUH EKSTRAK BUAH MENGKUDU (Morinda citrifolia)

    TERHADAP KADAR INTERFERON GAMMA (IFN-γ) TIKUS PUTIH

    JANTAN GALUR WISTAR (Rattus norvegicus L.) YANG DIINDUKSI

    OBAT ANTI TUBERKULOSIS (PIRAZINAMID, LEVOFLOKSASIN DAN

    ETAMBUTOL)

    OLEH :

    INDRA ARDIANSYAH

    201510330311067

    FAKULTAS KEDOKTERAN

    UNIVERSITAS MUHAMMADIYAH MALANG

    2019

  • KATA PENGANTAR

    Assalamu‟alaykum Warahmatullah Wabarakatuh

    Puji syukur kehadirat Allah Subhanahu Wata‟aala Yang Maha Pengasih

    lagi Maha Penyayang, karena atas rahmat dan izin-Nya penulisan karya tulis akhir

    ini dapat selesai dengan baik. Shalawat serta salam selalu tercurahkan kepada

    panutan umat manusia, Rasulullah Muhammad shalallahu alaihi wasallam,

    keluarganya dan para sahabatnya yang telah berjasa membawa syiar dakwah

    Islam ke seluruh dunia.

    Penelitian karya tulis akhir ini berjudul “Pengaruh Ekstrak Buah

    Mengkudu (Morinda Citrifolia) Terhadap Kadar Interferon Gamma (IFN-γ) Tikus

    Putih Jantan Galur Wistar (Rattus Norvegicus L.) Yang Diinduksi Obat Anti

    Tuberkulosis (Pirazinamid, Levofloksasin Dan Etambutol)”. Karya tulis akhir ini

    diajukan untuk memenuhi persyaratan Pendidikan Sarjana Fakultas Kedokteran

    Universitas Muhammadiyah Malang.

    Penulis menyadari karya tulis 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, Agustus 2019

    Penulis

  • DAFTAR ISI

    HASIL PENELITIAN ............................................................................................. ii

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

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

    LEMBAR PENGUJIAN ......................................................................................... v

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

    UCAPAN TERIMA KASIH ................................................................................. vii

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

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

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

    DAFTAR TABEL ................................................................................................. xv

    DAFTAR GAMBAR ........................................................................................... xvi

    DAFTAR LAMPIRAN ....................................................................................... xvii

    DAFTAR SINGKATAN ................................................................................... xviii

    BAB 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 ......................................................................................... 5

    1.4.1 Manfaat Akademis...................................................................................... 5

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

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

    BAB 2 KAJIAN PUSTAKA ................................................................................... 7

    2.1 Tuberkulosis .................................................................................................. 7

    2.1.1 Pengertian ............................................................................................... 7

    2.1.3 Faktor resiko ........................................................................................... 7

    2.1.2Etiologi..................................................................................................... 7

    2.1.4 Penularan ................................................................................................ 8

    2.1.5 Patogenesis.............................................................................................. 9

    2.1.6 Klasifikasi pasien TB ............................................................................ 11

  • 2.1.7 Klasifikasi berdasarkan riwayat pengobatan sebelumnya: ................... 12

    2.1.8 Klasifikasi berdasarkan hasil pemeriksaan uji kepekaan obat .............. 13

    2.2 Multi-drug Resistance Tuberkulosis (MDR TB) ......................................... 14

    2.2.1 Definisi.................................................................................................. 14

    2.2.2 Etiologi Munculnya MDR-TB .............................................................. 14

    2.2.3 Prinsip Terapi MDR- TB (Multi Drug Resistent Tuberculosis) ........... 15

    2.2.4 Obat MDR TB (Multi Drug Resistent Tuberculosis) ........................... 21

    2.3 Tanaman Mengkudu (Morinda citrifolia L) ................................................ 27

    2.3.1 Taksonomi ............................................................................................ 27

    2.3.2 Nama daerah ......................................................................................... 28

    2.3.3 Morfologi .............................................................................................. 28

    2.3.4 Manfaat Mengkudu ............................................................................... 29

    2.3.5 Kandungan Nutrisi Buah Mengkudu .................................................... 29

    2.4 Inflamasi ...................................................................................................... 32

    2.4.2 Interferon Gamma ................................................................................. 34

    2.5 Tikus Putih (Rattus norvegicus) .................................................................. 35

    BAB 3 KERANGKA KONSEP DAN HIPOTESIS ............................................. 37

    3.1. Kerangka Konsep ....................................................................................... 37

    3.2 Hipotesis Penelitian ..................................................................................... 39

    BAB 4 METODE PENELITIAN.......................................................................... 40

    4.1 Rancangan Penelitian .................................................................................. 40

    4.2 Tempat dan Waktu Penelitian ..................................................................... 40

    4.3 Populasi dan Sampel.................................................................................... 40

    4.3.1 Populasi ................................................................................................. 40

    4.3.2 Sampel .................................................................................................. 40

    4.3.3 Replikasi penelitian............................................................................... 41

    4.3.5 Karakteristik Sampel Penelitian............................................................ 42

    4.3.6 Variabel dan Definisi Operasional ........................................................ 43

    4.4 Definisi Operasional .................................................................................... 43

    4.4.1 Ektrak Mengkudu ................................................................................. 43

    4.4.2 IFN-γ .................................................................................................... 43

    4.5 Alat dan Bahan Penelitian .......................................................................... 44

  • 4.5.1 Alat Penelitian....................................................................................... 44

    4.5.2 Bahan penelitian ................................................................................... 44

    4.5.3 Alat dan Bahan Bedah Tikus ................................................................ 44

    4.6 Prosedur Penelitian ...................................................................................... 45

    4.6.1 Proses Adaptasi ..................................................................................... 45

    4.6.2 P