ABSTRAK
EFEK KOMBINASI HERBA JOMBANG (Taraxacum officinale Weber Et Wiggers) DAN MENIRAN (Phyllanthus niruri L.) TERHADAP REAKSI INFLAMASI PADA MENCIT JANTAN GALUR Swiss Webster DENGAN DERMATITIS ALERGIKA Lina Wijaya, 2009. Pembimbing I: dr. Diana K. Jasaputra, M.kes. Pembimbing II: Dra. Rosnaeni, Apt. Dermatitis alergika merupakan suatu reaksi inflamasi pada kulit, sehingga salah satu target pengobatannya adalah mengurangi reaksi inflamasi. Masyarakat menggunakan herbal seperti herba jombang dan meniran untuk mengatasi dermatitis. Penelitian ini bertujuan menilai efek antiinflamasi kombinasi herba jombang dan meniran terhadap pengurangan luas daerah peradangan dan jumlah sel radang pada mencit dermatitis alergika yang diinduksi ovalbumin. Penelitian eksperimental laboratorium ini bersifat prospektif dan komparatif menggunakan Rancangan Acak Lengkap (RAL). Hewan coba mencit diinduksi Ovalbumin 10% dan dibagi menjadi 5 kelompok (n=5) yang mendapat perlakuan dengan bahan uji kombinasi ekstrak etanol jombang (EEJ) dan ekstrak etanol meniran (EEM) dosis I (EEJ 0,39 mg + EEM 0,39 mg), II (EEJ 0,975 mg + EEM 0,975 mg), III (EEJ 0,39 mg + EEM 0,975 mg) per oral, kontrol positif, dan kelompok pembanding loratadin. Data yang diukur adalah luas daerah peradangan dan jumlah sel-sel radang, pada preparat histologi dengan pewarnaan HE jaringan kulit mencit. Hasil penelitian memperlihatkan bahwa kombinasi EEJ dan EEM: dosis I (6.330 mm2) dan dosis II (6.414 mm2) efektif mengurangi luas daerah peradangan dibandingkan dengan kontrol positif (17.792 mm2) (p≤0.05). Kombinasi EEJ dan EEM: dosis I (211.600), II (185.600), III (236.200) efektif mengurangi jumlah sel radang dibandingkan dengan kontrol positif (605.800) (p≤0.05). Kesimpulannya kombinasi EEJ dan EEM efektif mengurangi luas daerah peradangan dan jumlah sel radang dibandingkan dengan kontrol positif. Kata kunci: Inflamasi, Dermatitis Alergika, Kombinasi Ekstrak Etanol Jombang dan Meniran
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ABSTRACT
THE COMBINATION EFFECT OF DANDELION (Taraxacum officinale Weber Et Wiggers) AND PHYLLANTHUS (Phyllanthus niruri L.) HERB TO INFLAMMATION REACTION OF MALE MICE GALUR Swiss Webster WITH ALLERGIC DERMATITIS Lina Wijaya, 2009; Tutor I: dr. Diana K. Jasaputra, M.kes. Tutor II: Dra. Rosnaeni, Apt. Allergic dermatitis is an inflammatory reaction on skin, one of the target therapy is reducing inflammatory reaction. People use herb such as dandelion and phyllanthus herb to treat dermatitis. The aim of this research is to know the antiinflammatory effect of combination dandelion and phyllanthus herb to decrease the inflammation coverage and number of inflammation cells in mice with allergic dermatitis. This comparative, prospective experimental laboratories used Complete Random Design. The mice as experimental animal were induced by 10% Ovalbumin and divided 5 groups (n=5) that treated with dose I (EEJ 0,39 mg + EEM 0,39 mg), II (EEJ 0,975 mg + EEM 0,975 mg), III (EEJ 0,39 mg + EEM 0,975 mg) oral substances of combination dandelion (DEE) and phyllanthus ethanol extract (PEE), positive control group, and loratadin comparative group. The collected data are inflammation coverage and number of inflammation cells at histology preparate with HE staining skin tissue from mice. The experimental result show that dose I of combination DEE and PEE: (6.330 mm2) and dose II (6.414 mm2) are effectively decreasing inflammation coverage againts control positive group (17.792 mm2) (p≤0.05). Dose I of combination DEE and PEE: (211.600), dose II (185.600), and dose III (236.200) are effectively decreasing inflammation cells againts control positive group (605.800) (p≤0.05). The conclusion is combination DEE and PEE are effectively decreasing inflammation coverage and number of inflammation cells. Key words: Inflammation, Allergic Dermatitis, Combination of Dandelion and Phyllanthus Ethanol Extract
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DAFTAR ISI
Halaman JUDUL ................................................................................................................. i LEMBAR PERSETUJUAN.................................................................................ii SURAT PERNYATAAN ...................................................................................iii ABSTRAK ......................................................................................................... iv ABSTRACT.......................................................................................................... v KATA PENGANTAR ........................................................................................ vi DAFTAR ISI ....................................................................................................viii DAFTAR TABEL .............................................................................................. xi DAFTAR GAMBAR ........................................................................................ xii DAFTAR LAMPIRAN..................................................................................... xiv BAB I
PENDAHULUAN................................................................................. 1 1.1 Latar Belakang ................................................................................ 1 1.2 Identifikasi Masalah ........................................................................ 2 1.3 Maksud dan Tujuan Penelitian......................................................... 3 1.4 Manfaat Karya Tulis Ilmiah............................................................. 3 1.5 Kerangka Pemikiran dan Hipotesis .................................................. 4 1.5.1 Kerangka Pemikiran................................................................ 4 1.5.2 Hipotesis................................................................................. 5 1.6 Metodologi Penelitian...................................................................... 6 1.7 Lokasi dan Waktu Penelitian ........................................................... 6
BAB II TINJAUAN PUSTAKA........................................................................ 7 2.1 Jaringan kulit ................................................................................... 7 2.2 Inflamasi ......................................................................................... 8 2.2.1 Inflamasi Akut ...................................................................... 10 2.2.1.1 Perubahan Vaskular................................................... 11 2.2.1.2 Fase Selular............................................................... 14 2.2.1.3 Mediator-Mediator Kimia.......................................... 16 2.2.1.4 Amin Vasoaktif ......................................................... 18 2.1.1.4.1 Histamin ..................................................... 18 2.1.1.4.2 Serotonin .................................................... 18 2.2.1.5 Protein Plasma........................................................... 19 2.2.1.6 Metabolit Asam Arakidonat, Prostaglandin, dan Leukotrien................................................................. 21 2.2.1.7 Nitrit Oksida (NO) .................................................... 23 viii
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2.2.1.8 Oksigen Radikal Bebas (Oxygen-derived free radicals) .................................................................................. 25 2.1.1.9 NF-kappaB................................................................ 26 2.2.2 Inflamasi Kronik................................................................... 29 2.3 Reaksi Hipersensitivitas................................................................. 30 2.3.1 Reaksi Hipersensitivitas Tipe I (Anaphilactic)....................... 31 2.3.2 Reaksi Hipersensitivitas Tipe II (Cytotoxic Hypersensitivity) 32 2.3.3 Reaksi Hipersensitivitas Tipe III (Immune-complex Hypersensitivity) ................................................................... 33 2.3.4 Reaksi Hipersensitivitas Tipe IV (Delayed/Cell-mediated Hypersensitivity) .................................................................. 33 2.4 Dermatitis Atopik .......................................................................... 34 2.4.1 Definisi................................................................................. 34 2.4.2 Etiopatogenesis ..................................................................... 34 2.4.3 Manifestasi Klinik ................................................................ 36 2.4.3.1 Bentuk Infantil .......................................................... 36 2.4.3.2 Bentuk Anak (3-11 tahun) ......................................... 37 2.4.3.3 Bentuk Remaja dan Dewasa (12-30 tahun) ................ 38 2.4.4 Diagnosis.............................................................................. 39 2.4.5 Diagnosis Banding................................................................ 40 2.4.6 Penatalaksanaan.................................................................... 40 2.4.7 Pengobatan ........................................................................... 41 2.4.7.1 Pengobatan Sistemik ................................................. 42 2.4.7.2 Pengobatan Topikal................................................... 42 2.5 Jombang (Taraxacum officinale Weber et Wiggers) ....................... 42 2.5.1 Luteolin ................................................................................ 45 2.5.2 Apigenin ............................................................................... 46 2.6 Meniran (Phyllanthus niruri L.)..................................................... 46 2.5.1 Quercetin.............................................................................. 48 BAB III METODE PENELITIAN .................................................................... 50 3.1 Alat dan Bahan.............................................................................. 50 3.2 Persiapan Penelitian....................................................................... 51 3.2.1 Hewan Percobaan Penelitian ................................................. 51 3.2.2 Bahan Uji ............................................................................. 51 3.3 Metode Penelitian.......................................................................... 52 3.3.1 Penentuan Besar Sampel ....................................................... 52 3.3.2 Variabel Penelitian................................................................ 52 3.3.3 Prosedur Penelitian ............................................................... 53 BAB IV HASIL PENELITIAN DAN PEMBAHASAN .................................... 57 4.1 Hasil Penelitian ............................................................................. 57 4.2 Pembahasan................................................................................... 61 4.3 Uji Hipotesis ................................................................................. 62 BAB V KESIMPULAN DAN SARAN............................................................ 67
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5.1 Kesimpulan ................................................................................... 67 5.2 Saran ............................................................................................. 68 DAFTAR PUSTAKA ........................................................................................ 69 LAMPIRAN ...................................................................................................... 73 RIWAYAT HIDUP ........................................................................................... 79
DAFTAR TABEL
Halaman Tabel 2.1 Stimulus-Stimulus yang Mengaktivasi NF-kappaB ............................................ 27
Tabel 2.2 Protein-Protein yang Diregulasi oleh NF-kappaB............................................... 28
Tabel 4.1 Hasil Penelitian Pengaruh kombinasi EEJ dan EEM terhadap Luas Daerah Peradangan pada Mencit yang Diinduksi Ovalbumin. ........................................ 57
Tabel 4.2 Uji Statistik Penelitian dengan Bahan Uji Kombinasi EEJ dan EEM dengan Parameter Luas Daerah Peradangan ................................................................... 59
Tabel 4.3 Hasil Penelitian Pengaruh Kombinasi EEJ dan EEM terhadap Jumlah Sel-Sel Radang pada Mencit yang Diinduksi Ovalbumin. .............................................. 59
Tabel 4.4 Uji Statistik Penelitian dengan Bahan Uji Ekstrak Air Meniran dengan Parameter Jumlah Sel-Sel Radang ...................................................................................... 61
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DAFTAR GAMBAR
Halaman
Gambar 2.1 Struktur anatomi kulit .............................................................................7 Gambar 2.2 Proses Inflamasi .....................................................................................9 Gambar 2.3 Manifestasi Lokal Utama dalam inflamasi akut dibandingkan dengan gambaran normal ..................................................................................10 Gambar 2.4 Perjalanan Leukosit dalam Pembuluh Darah .........................................15 Gambar 2.5 Hubungan antara Empat Sistem Mediator yang Dipicu oleh Aktivasi Faktor XII.............................................................................................21 Gambar 2.6 Hasil Metabolit Asam Arakidonat dan Peran Masing-Masing Metabolit dalam Proses Inflamasi .........................................................................22 Gambar 2.7 Diagram Skematik dari NF-kappaB sebagai Regulator Inflamasi ......... 27 Gambar 2.8 Hasil dari Proses Inflamasi: Resolusi, Perbaikan oleh Jaringan Fibrosis, dan Inflamasi Kronik ............................................................................30 Gambar 2.9 Anak dengan Dermatitis Atopi..............................................................34 Gambar 2.10 Bagan pathogenesis Dermatitis Atopik................................................35 Gambar 2.11 Dermatitis Atopi Bentuk Infantil.........................................................37 Gambar 2.12 Dermatitis Atopi Bentuk Anak............................................................37 Gambar 2.13 Dermatitis Atopi Bentuk Dewasa........................................................38 Gambar 2.14 Herba Jombang (Taraxacum officinale Weber et Wiggers)..................43 Gambar 2.15 Herba Jombang (Taraxacum officinale Weber et Wiggers)..................43 Gambar 2.16 Herba Meniran (Phyllanthus niruri L.)................................................47 Gambar 4.1 Diagram Batang Hasil Pengaruh Kombinasi EEJ dan EEM terhadap Parameter Luas Daerah Peradangan ......................................................58
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Gambar 4.2 Diagram Batang Hasil Pengaruh Kombinasi EEJ dan EEM terhadap Parameter Jumlah Sel Radang ...............................................................60
DAFTAR LAMPIRAN
Halaman Lampiran 1 Perhitungan dosis.....................................................................................................74
Lampiran 2 Alur Cara Kerja .......................................................................................................75
Lampiran 3 Uji Statistik Hasil Penelitian Pengaruh kombinasi EEJ dan EEM terhadap Luas Daerah Peradangan pada Mencit yang Diinduksi Ovalbumin ...................................76
Lampiran 4 Uji Statistik Hasil Penelitian Pengaruh Kombinasi EEJ dan EEM terhadap Jumlah Sel-Sel Radang pada Mencit yang Diinduksi Ovalbumin .........................................77
Lampiran 5 Gambar Hasil Pengamatan Mikroskopik Jaringan Kulit Mencit Dosis 1 dengan Perbesaran 100x.......................................................................................................78
Lampiran 6 Gambar Hasil Pengamatan Mikroskopik Jaringan Kulit Mencit Dosis 2 dengan Perbesaran 100x.......................................................................................................78
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Lampiran 7 Gambar Hasil Pengamatan Mikroskopik Jaringan Kulit Mencit Dosis 3 dengan Perbesaran 100x.......................................................................................................79