KARYA TULIS AKHIR PENGARUH PEMBERIAN EKSTRAK DAUN KELOR (Moringa oleifera) TERHADAP KADAR HEMOGLOBIN PADA TIKUS STRAIN WISTAR YANG DIINDUKSI ALUMINIUM KLORIDA
Oleh : Nur Aisah Ibrahimiyah 201010330311018
UNIVERSITAS MUHAMMADIYAH MALANG FAKULTAS KEDOKTERAN 2014
LEMBAR PENGESAHAN LAPORAN HASIL PENELITIAN Telah disetujui sebagai hasil penelitian untuk memenuhi persyaratan Pendidikan Sarjana Fakultas Kedokteran Universitas Muhammadiyah Malang Pembimbing I
dr. Sulistyo Mulyo Agustini, Sp.PK NIP. 11305010417 Pembimbing II
dr. Gita Sekar Prihanti, M.Pd.Ked NIP. 11308090463 Mengetahui, Fakultas Kedokteran Dekan,
dr. Irma Suswati, M.Kes
NIP. 11395010320
Karya Tulis Akhir oleh Nur Aisah Ibrahimiyah ini telah diuji dan dipertahankan di depan Tim Penguji pada tanggal 2 April 2014.
Tim Penguji
dr. Sulistyo Mulyo Agustini, Sp.PK
Ketua
dr. Gita Sekar Prihanti, M.Pd.Ked
Anggota
dr. Melany Farahdilla, M.Kes, Sp.A
Anggota
KATA PENGANTAR
Puji syukur penulis panjatkan kehadirat Allah SWT karena atas rahmat dan hidayah-Nya, penulisan tugas akhir ini dapat diselesaikan dengan baik. Sholawat serta salam semoga selalu tercurahkan kepada Rasulullah SAW, keluarga, para sahabat dan pengikut beliau hingga akhir zaman. Penelitian dalam tugas akhir ini berjudul “Pengaruh Pemberian Ekstrak Daun Kelor (Moringa oleifera) terhadap Kadar Hemoglobin Pada Tikus Strain Wistar Anemia yang Diinduksi Aluminium Klorida”. Tugas akhir ini diajukan untuk memenuhi persyaratan Pendidikan Sarjana Fakultas Kedokteran Universitas Muhammadiyah Malang. Pada kesempatan ini, penulis menyampaikan terima kasih yang sebesarbesarnya kepada : 1.
dr. Irma Suswati, M.Kes, selaku Dekan Fakultas Kedokteran Universitas Muhammadiyah Malang atas bimbingannya selama di FK-UMM.
2.
dr. Mochammad Ma’roef, Sp.OG, selaku Pembantu Dekan I Fakultas Kedokteran Universitas Muhammadiyah Malang atas bimbingannya selama di FK-UMM.
3.
dr. Rahayu, Sp.S, selaku Pembantu Dekan II Fakultas Kedokteran Universitas Muhammadiyah Malang atas bimbingannya selama di FK-UMM.
4.
dr. Iwan Sis Indrawanto, SpKJ, selaku Pembantu Dekan III Fakultas Kedokteran Universitas Muhammadiyah Malang atas bimbingannya selama di FK-UMM.
5.
dr. Sulistyo Mulyo Agustini, Sp.PK, selaku pembimbing I, atas bimbingan dan kesabaran serta motivasi sehingga dapat menyelesaikan penelitian ini dengan baik.
6.
dr. Gita Sekar Prihanti, M.Pd.Ked selaku pembimbing II, atas bimbingan dan kesabaran sehingga penulis dapat menyelesaikan penelitian ini dengan baik.
7.
dr. Melany Farahdilla, M.Kes, Sp.A, selaku penguji tugas akhir ini, terima kasih atas motivasi dan masukan-masukanya yang sangat membantu dalam penyelesaian tugas akhir ini.
8.
Bapak H.Muhammad Nawi, S.H, M.Hum, Ibu Hj.Yuni Asminiarti, Kakak Nurul Latifah S.Psi, Kakak Ipar Putut Wijanarko yang selalu memberikan motivasi, semangat, doa yang tidak pernah berhenti dalam menyelesaikan tugas akhir ini.
9.
Seluruh laboran Laboraturium Farmakologi dan Laboran Laboraturium Biomedik FK-UMM yang telah membantu dalam proses penelitian ini.
10. Seluruh Laboran Laboratorium Skill FK-UMM Mbak Emi dan Mbak Dilla, serta seluruh asisten 2010 Dywangga, Frida, Rischa, Ayu, Dinda, Yusrin sang telah memberikan banyak cerita selama mengabdi di Lab-skill. 11. Shelly Andrianty sebagai teman, sahabat, saudara dari TK sampai saat ini, suka duka sudah dilalui bersama hingga bisa menyelesaikan tugas akhir dalam waktu yang bersamaan pula, semoga barokah persahabatan ini.
12. Jeany, Donna, Ratri, Dahlia, Gilang, Surya, Danu, Abror sebagai temanteman yang telah memberikan canda tawa setiap kali kebosanan melanda selama proses pengerjaan tugas akhir. 13. Wulan, Vivi, Enis, Tika, Echa, Iva Naay, Dywangga, Indah, Nisak, Betty, Nadia April, Inas, Panahasini sebagai partner di kampus ini yang selalu memberikan motivasi, doa dan warna-warni kehidupan selama kuliah hingga saat ini. 14. Teman-teman FK-UMM 2010, terimakasih atas bantuan dan hari-hari yang menyenangkan selama menempuh pendidikan dokter FK-UMM. 15. Semua pihak yang terlibat langsung maupun tidak langsung yang tidak mampu penulis sebutkan satu-persatu, terima kasih atas dukungan dan doanya. Dengan segala kerendahan hati penulis mohon maaf sebesar-besarnya bila tugas akhir ini masih jauh dari kata sempurna, untuk itu penulis mengharapkan kritik dan saran yang membangun. Semoga karya tulis ini dapat bermanfaat. Malang, 07 April 2014
Penulis
DAFTAR ISI
Halaman judul ..................................................................................................... i Lembar pengesahan ............................................................................................. iii Lembar penguji ................................................................................................... iv Kata Pengantar .................................................................................................... v Abstrak ............................................................................................................... viii Abstract .............................................................................................................. ix Daftar isi .............................................................................................................. x Daftar gambar..................................................................................................... xiii Daftar tabel ......................................................................................................... xiv Daftar lampiran .................................................................................................. xv Daftar singkatan ................................................................................................. xvi Bab I Pendahuluan 1.1 Latar Belakang ................................................................................................ 1 1.2 Rumusan Masalah .......................................................................................... 2 1.3 Tujuan Penelitian ............................................................................................ 2 1.3.1 Tujuan Umum .................................................................................. 2 1.3.2 Tujuan Khusus.................................................................................. 2 1.4 Manfaat Penelitian .......................................................................................... 3 1.4.1 Manfaat Akademis .............................................................................. 3 1.4.2 Manfaat Klinis .................................................................................... 3 1.4.3 Manfaat Untuk Masyarakat ............................................................... 3 Bab II Tinjauan Pustaka 2.1 Zat Besi .......................................................................................................... 4 2.1.1 Metabolisme Zat Besi ........................................................................ 5 2.1.2 Kekurangan dan Kelebihan Zat Besi .................................................. 8 2.2 Anemia Defisiensi Besi ............................................................................... .. 9 2.2.1 Etiologi Anemia Defisiensi Besi ..................................................... 10 2.2.2 Gejala Klinis Anemia Defisiensi Besi ............................................. 12 2.2.3 Diagnosis Anemia Defisiensi Besi ...................................................13 2.3 Eritropoesis ..................................................................................................16 x
2.4 Tanaman Kelor ..............................................................................................19 2.4.1 Klasifikasi Tanaman Kelor ...............................................................19 2.4.2 Karakteristik Umum Tanaman Kelor ...............................................21 2.4.3 Kandungan Nutrisi Daun Kelor ........................................................23 2.4.4 Manfaat Tanaman Kelor Secara Umum ...........................................24 2.5 Aluminium Klorida .......................................................................................25 2.6 Hubungan Antara Daun Kelor dengan Hemoglobin .....................................26 Bab III Kerangka Konsep 3.1 Kerangka Konsep .........................................................................................29 3.2 Hipotesis penelitian .......................................................................................31 Bab IV Metodologi Penelitian 4.1 Jenis Penelitian ..............................................................................................32 4.2 Lokasi dan Waktu Penelitian ........................................................................32 4.3 Populasi dan Sampel .....................................................................................32 4.3.1 Populasi ............................................................................................32 4.3.2 Sampel ..............................................................................................32 4.3.3 Besar Sampel ....................................................................................32 4.3.4 Teknik Pengambilan Sampel ............................................................33 4.3.5 Karakteristik Sampel Penelitian .......................................................33 4.3.6 Variabel Penelitian............................................................................34 4.3.7 Definisi Operasional Variabel ..........................................................34 4.4 Alat dan Bahan ..............................................................................................35 4.4.1 Alat ...................................................................................................35 4.4.2 Bahan ................................................................................................36 4.5 Prosedur Penelitian........................................................................................37 4.5.1 Pembagian Kelompok Tikus ............................................................37 4.5.2 Adaptasi Hewan Coba ......................................................................38 4.5.3 Penentuan Dosis................................................................................38 4.5.4 Pembuatan Ekstrak Serbuk Daun Kelor ...........................................38 4.5.5 Pembuatan Aluminium Klorida ........................................................39 4.5.7 Percobaan..........................................................................................40 4.6 Alur Penelitian ..............................................................................................42 xi
4.7 Analisis Data .................................................................................................43 Bab V Hasil Penelitian dan Analisis Data 5.1 Hasil Penelitian ............................................................................................ 44 5.2 Analisis Data ................................................................................................ 45 Bab VI Pembahasan Pembahasan ........................................................................................................ 50 BAB VII Kesimpulan dan Saran 7.1 Kesimpulan .................................................................................................. 59 7.2 Saran ............................................................................................................. 59 Daftar Pustaka .................................................................................................... 60 Lampiran
xii
DAFTAR GAMBAR Gambar 2.1 Urutan Tahapan Defisiensi Besi ..................................................................... 10 2.2 Kadar Hemoglobin Pada Setiap Kelompok Usia ............................................ 15 2.3 Klasifikasi Anemia Berdasarkan Kadar Hemoglobin ..................................... 16 2.4 Sitokin yang Mempengaruhi Eritropoesis ...................................................... 17 2.5 Pembentukan Eritrosit (Eritropoesis) .............................................................. 18 2.6 Tanaman Kelor................................................................................................ 20 2.7 Pohon Kelor .................................................................................................... 21
xiii
DAFTAR TABEL Tabel 2.1 Angka Kecukupan Zat Besi ............................................................................ 4 2.2 Penyebab Anemia Defisiensi Besi Berdasarkan Umur ................................... 12 2.3 Perbandingan Kandungan Zat Gizi Pada Berbagai Sediaan Daun Kelor (Moringa oleifera) ................................................................................................ 23 2.4 Kandungan Asam amino Moringa oleifera………………………………
23
2.5 Kandungan Vitamin dan Mineral Moringa oleifera……………………..
24
xiv
DAFTAR LAMPIRAN Lampiran 1: Dokumentasi..................................................................................... 66 Lampiran 2: Data Hasil Pengukuran Kadar Hemoglobin ..................................... 70 Lampiran 3: Data Statistik .................................................................................... 71 Lampiran 4: Surat Etika Penelitian ....................................................................... 75 Lampiran 5: Lembar konsultasi tugas akhir.......................................................... 76
xv
DAFTAR SINGKATAN AlCl 3
: Aluminium Klorida
BasoE
: Basophilic Normoblast
CDC
: Centers for Disease Control and Prevention
EPO
: Eritropoetin
G-CSF
: Granulocyte-Colony Stimulating Factor
GM-CSF
: Granulocyte Macrophage-Colony Stimulating Factor
Hb
: Hemoglobin
IGF
: Insulin Growth Factor
IL
: Interleukin
MCH
: Mean Corpuscular Hemoglobin
MCHC
: Mean Corpuscular Hemoglobin Concentration
MCV
: Mean Corpuscular Volume
OrthoE
: Orthochromatophilic Normoblast
PolyE
: Polychromatophilic Normoblast
ProE
: Pronormoblast
RDW
: Red cell Distribution Width
SCF
: Stem Cell Factor
SD
: Standart Deviation
SDM
: Sel Darah Merah
UV
: Ultra Violet
WHO
: World Health Organization
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