KARYA TULIS AKHIR
Pengaruh Ekstrak Jahe Merah ( Zingiber officinale Roscoe ) terhadap Gambaran IL-6
pada Tikus Putih (Rattus norvegicus) Strain Wistar yang diinduksi oleh Pirazinamid,
Etambutol, Levofloksasin
OLEH
AGRA MEDHA WISESA
201510330311177
UNIVERSITAS MUHAMMADIYAH MALANG
FAKULTAS KEDOKTERAN
2019
Pengaruh Ekstrak Jahe Merah ( Zingiber officinale Roscoe ) terhadap Gambaran IL-6
pada Tikus Putih (Rattus norvegicus) Strain Wistar yang diinduksi oleh Pirazinamid,
Etambutol, Levofloksasin
KARYA TULIS AKHIR
Diajukan kepada
Universitas Muhammadiyah Malang
Untuk Memenuhi Salah Satu Persyaratan
Dalam Menyelesaikan Program Sarjana
Fakultas Kedokteran
Oleh:
Agra Medha Wisesa
201510330311177
UNIVERSITAS MUHAMMADIYAH MALANG
FAKULTAS KEDOKTERAN
2019
LEMBAR PENGESAHAN
LAPORAN HASIL PENELITIAN
PERNYATAAN ORISINALITAS
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 Jahe Merah ( Zingiber officinale
Roscoe ) terhadap Gambaran IL-6 pada Tikus Putih (Rattus norvegicus) Strain Wistar yang
diinduksi oleh Pirazinamid, Etambutol, Levofloksasin. 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, 18 Juli 2019
Penulis
UCAPAN TERIMAKASIH
1. Bapak Djoko Wahjoediono, Ibu Nurjati, Kakak Kallida Nariswari, Kakak
Adhyaksa Mahardika dan Kembaran saya Pramodana Medha Wisesa, atas
dukungan moril dan materiil, juga telah menjadi sumber semangat penulis
untuk bisa menyelesaikan tugas akhir ini.
2. dr. Thontowi Djauhari, NS., M.Kes, selaku pembimbing 1, atas kesabaran,
kebaikan hati, serta kesediaan dalam meluangkan waktu serta membimbing
penulis sehingga tugas akhir ini dapat diselesaikan dengan baik.
3. dr. Feny Tunjungsari, M.Kes, selaku pembimbing 2, atas kesabaran, kebaikan
hati, serta kesediaan dalam meluangkan waktu serta membimbing penulis
sehingga tugas akhir ini dapat diselesaikan dengan baik.
4. dr. Anung Putri Illahika, M.Si, selaku penguji tugas akhir ini, atas segala
masukan dan arahan yang sangat bermanfaat dalam pengerjaan tugas akhir
sehingga tugas akhir ini dapat diselesaikan dengan baik.
5. Dr. dr. Meddy Setiawan, Sp.PD, selaku Dekan Fakultas Kedokteran
Universitas Muhammadiyah Malang atas ilmu dan bimbingannya selama di
Fakultas Kedokteran UMM.
6. dr. Moch. Ma’roef, Sp.OG, selaku Wakil Dekan I Fakultas Kedokteran UMM
atas kesediaan waktu dan penyampaian ilmu yang sangat bermanfaat bagi
masa depan para mahasiswa FK UMM.
7. dr. Sri Adila Nurainiwati, Sp.KK, selaku Wakil Dekan II Fakultas Kedokteran
UMM yang senantiasa bersabar dalam membimbing dan mengajarkan
ilmunya kepada kami.
8. dr. Indra Setiawan, Sp.THT-KL, selaku Wakil Dekan III, yang penuh
semangat dalam menyampaikan ilmu dan motivasi yang membangun
semangat kami selama menjalani pendidikan di Fakultas Kedokteran.
9. MEARS (Medical and Health Research), dr. Anung Putri Ilahika, M.Si,
selaku komisi ilmiah Fakultas Kedokteran Universitas Muhammadiyah
Malang.
10. Seluruh staf TU dan laboran, Mas Nyono, Ibu Patma, Pak Joko dan Mas
Miftah yang bersedia membantu setiap tahapan proses penelitian hingga
tugas akhir ini selesai.
11. Muhammad Furkan, Abdillah Budi Ksatria dan Duwi Hikmatullah yang telah
menjadi teman terbaik dalam memberikan masukkan-masukkan yang
membangun dalam proses pengerjaan tugas akhir ini.
12. Alim Muhaimin dan Raffian Yusuf selaku teman yang tak pernah lelah
untuk selalu memotivasi dan mengingatkan agar selalu tetap dijalan
kebenaran.
13. Cendra Mulya sebagai kawan seperjuangan yang selalu memberikan
kekuatan dalam proses pengerjaan tugas akhir ini.
14. Sejawat FK UMM angkatan 2015, Metacarpal, atas dukungan, bantuan, dan
kerjasamanya. Semoga kelak dapat menjadi dokter-dokter profesional yang
selalu diberikan keberkahan dalam pengabdiannya, dan sukses dunia akhirat,
serta senaantiasa dalam ketaatan kepada Allah Subhanahu Wata’ala.
15. Semua pihak yang telah terlibat langsung maupun tidak langsung, terima
kasih atas bantuan dan dukungannya.
DAFTAR ISI
LEMBAR PENGESAHAN ........................................................................................... iii
LEMBAR PENGUJIAN…………………………………………………………....……..iv
PERNYATAAN ORISINALITAS ................................................................................ v
KATA PENGANTAR ................................................................................................... vi
UCAPAN TERIMAKASIH .......................................................................................... vii
DAFTAR ISI ................................................................................................................. ix
DAFTAR TABEL ......................................................................................................... xii
DAFTAR GAMBAR ..................................................................................................... xiii
DAFTAR SINGKATAN ............................................................................................... xiv
DAFTAR LAMPIRAN ................................................................................................. xv
ABSTRAK ..................................................................................................................... xvi
ABSTRACT................................................................................................................... xvii
BAB 1 PENDAHULIAN ............................................................................................... 1
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
1.4.2Manfaat Klinis................................................................................................ 3
1.4.3Manfaat Masyarakat ....................................................................................... 3
BAB 2 TINJAUAN PUSTAKA..................................................................................... 4
2.1. Pirazinamid (PZA/Z) ......................................................................................... 4
2.1.1. Definisi ........................................................................................................ 4
2.1.2. Efikasi pada manusia .................................................................................... 4
2.1.3. Keamanan dan efek samping ........................................................................ 4
2.2. Etambutol (EMB/E) ........................................................................................... 5
2.2.1. Definisi ........................................................................................................ 5
2.2.2. Efikasi pada manusia .................................................................................... 5
2.2.3. Keamanan dan efek samping ........................................................................ 6
2.3. Levofloxacin (Lfx) .............................................................................................. 6
2.3.1. Definisi ........................................................................................................ 6
2.3.2. Efikasi pada manusia .................................................................................... 7
2.3.3. Kemananan dan efek samping ...................................................................... 7
2.4. Respon Inflamasi ............................................................................................... 8
2.4.1. Pengertian Inflamasi ..................................................................................... 8
2.4.2. Proses Inflamasi Akut ................................................................................... 9
2.4.3. Proses Inflamasi Kronis .................................................................................. 10
2.5. Interleukin 6 (IL-6) ............................................................................................ 11
2.6. Jahe Merah (Zingiber officinale Roscoe.) ......................................................... 13
2.6.1. Taksonomi Jahe Merah ................................................................................ 13
2.6.2 Deskripsi Tanaman Jahe Merah ..................................................................... 14
2.6.3 Kandungan Jahe Merah ................................................................................. 14
2.6.4 Manfaat Jahe Merah ...................................................................................... 15
2.7. Tikus Putih (Rattus Novergicus) ....................................................................... 17
2.7.3. Taksonomi Tikus Putih ................................................................................. 17
2.7.4. Deskripsi Tikus Putih ................................................................................... 17
BAB 3 KERANGKA KONSEP .................................................................................... 18
3.1. Kerangka Konsep ................................................................................................... 18
3.2. Hipotesis Penelitian ................................................................................................ 20
BAB 4 METODE PENELITIAN .................................................................................. 21
4.1 Jenis dan Rancangan Penelitian ......................................................................... 21
4.2. Tempat dan Waktu Penelitian........................................................................... 21
4.3. Populasi dan Sampel .......................................................................................... 21
4.3.1 Populasi ........................................................................................................ 21
4.3.2 Sampel .......................................................................................................... 21
4.3.3 Besar Sampel ................................................................................................ 21
4.3.4 Teknik Sampling ........................................................................................... 23
4.4. Karakteristik sampel penelitian ........................................................................ 23
4.4.1. Kriteria Inklusi : ........................................................................................... 23
4.4.2. Kriteria Eksklusi :......................................................................................... 23
4.4.3. Kriteria drop out: .......................................................................................... 23
4.5. Variabel Penelitian ............................................................................................ 23
4.5.1. Variabel Bebas ............................................................................................. 23
4.5.2. Variabel Tergantung ..................................................................................... 23
4.6. Definisi Operasional........................................................................................... 24
4.7. Bahan dan Instrumen Penelitian ....................................................................... 24
4.7.1. Bahan ........................................................................................................... 24
4.7.2. Alat .............................................................................................................. 25
4.8. Prosedur Penelitian ............................................................................................ 26
4.8.1. Adaptasi ....................................................................................................... 26
4.8.2. Pengelompokan tikus.................................................................................... 27
4.8.3. Pembuatan sediaan ekstrak rimpang jahe merah ........................................... 28
4.8.4. Pemberian Ekstrak Rimpang Jahe Merah ...................................................... 28
4.8.5. Pemberian obat anti tuberkulosis .................................................................. 29
4.8.6. Proses Anastesi............................................................................................. 31
4.8.7. Pengukuran Kadar IL-6 ................................................................................ 31
4.8.8. Penanganan Hewan Coba ............................................................................. 31
4.9. Alur Penelitian ................................................................................................... 32
4.10. Teknik Pengumpulan Dan Analisis Data ........................................................ 33
4.10.1. Teknik Pengumpulan Data .......................................................................... 33
4.11. Analisis Data .................................................................................................... 33
4.12. Jadwal Penelitian ............................................................................................. 34
BAB 5 HASIL PENELITIAN DAN ANALISIS DATA............................................... 35
5.1 Hasil Penelitian ................................................................................................... 35
5.2 Analisis Data ....................................................................................................... 36
5.2.1 Uji Normalitas ............................................................................................... 36
5.2.3 Uji One-Way ANOVA .................................................................................. 37
5.2.4 Uji Post-hoc ................................................................................................. 38
5.2.5 Regresi Linear .............................................................................................. 39
BAB 6 PEMBAHASAN ................................................................................................ 40
BAB 7 KESIMPULAN DAN SARAN .......................................................................... 44
7.1 Kesimpulan ......................................................................................................... 44
7.2 Saran ................................................................................................................... 44
DAFTAR PUSTAKA .................................................................................................... 45
LAMPIRAN .................................................................................................................. 50
DAFTAR TABEL
Tabel Halaman
2.1. Kandungan Fitokima Rimpang Jahe Merah.................................................15
2.2. Aktivitas biologik senyawa dalam jahe…………………………………....16
4.1. Tabel Definisi Operasional ....................................................................... 24
4.2. Tabel Penentuan Dosis MDR-TB berdasarkan Kelompok Berat Badan ..... 29
4.3. Konversi Penghitungan Dosis .................................................................. 29
4.4. Tabel Jadwal Penelitian ............................................................................ 34
5.1. Tabel Data Hasil Penelitian ...................................................................... 35
5.2. Hasil Uji Saphiro Wilk ............................................................................. 36
5.3. Uji Levene Test ........................................................................................ 37
5.4. Hasil Uji One-way Anova ......................................................................... 37
5.5. Uji post hoc Bonferroni ............................................................................ 38
5.6. Regresi Linear .......................................................................................... 39
DAFTAR GAMBAR
Gambar Halaman
2.1. Tanaman Jahe Merah (Zingiber officinale Roscoe) .......................................... 13
2.2. Rimpang Jahe Merah (Zingiber officinale Roscoe)........................................... 14
2.3. Rattus norvegicus strain wistar ........................................................................ 17
3.1. Kerangka Konsep ............................................................................................ 18
DAFTAR SINGKATAN
APP : Acute Phase Protein.
CSF : Cerebrospinal Fluid.
DM : Diabetes Melitus
DNA : Deoxyribo Nucleic Acid.
DOTS : Directly Observed Treatment Short- course.
ELISA : Enzyme-Linked Immunosorbent Assay.
EMB : Etambutol
FDA : Food and Drug Agency
GF : Growth Factor.
IFN : Interferon.
IL-1 : Interleukin-1.
IL-6 : Interleukin-6.
INH : Isoniazid.
LFX : Levofloxacin
M : Metionin
MDR : Multi-Drug Resistant.
NK-CELL : Natural Killer Cell.
RIF : Rifampisin
OAT : Obat Anti Tuberkulosis.
PZA : Pirazinamid
STR : Streptomisin
TB : Tuberkulosis.
TB-MDR : Tuberculosis Multi-drug Resistant.
Th : T-helper.
TNF : Tumor Necrosis Factor.
WHO : World Health Organization.
DAFTAR LAMPIRAN
Lampiran Halaman
1. Dokumentasi ....................................................................................... 50
2. Hasil Pengamatan ................................................................................ 53
3. Hasil Analisis Statistik ......................................................................... 54
4. Surat Determinasi Buah Jahe ................................................................ 56
5. Surat Etik Penelitian ............................................................................ 57
6. Surat Keterangan Telah Melaksanakan Penelitian ................................ 58
7. Surat Keterangan Lolos Uji Plagiasi FK UMM ................................... 59
8. Surat Keterangan Lolos Komisi Ilmiah (Mears) .................................. 60
9. Lembar Bimbingan Konsultasi Tugas Akhir…………………………...61
DAFTAR PUSTAKA
Abdel-Azeem, A. S., Hegazy, A. M., Ibrahim, K. S., Farrag, A.-R. H. and El-Sayed, E. M. 2013.
Hepatoprotective, antioxidant, and ameliorative effects of ginger (Zingiber officinale Roscoe)
and vitamin E in acetaminophen treated rats. J Diet Suppl. 10(3), pp. 195–209.
Arifin W N, Zahiruddin W M, 2017, Sample Size Calculation in Animal Studies Using Resource
Equation Approach, Journal Malaysia Medical Science, 24, pp. 101-105.
Baratawidjaja Karnen, Rengganis Iris. 2010. Imunologi dasar edisi ke-10. Jakarta : Balai Penerbit
FKUI. pp. 228-259.
Bellik, Y., 2014. Total antioxidant activity and antimicrobial potency of the essential oil and
oleoresin of Zingiber officinale Roscoe. Asian Pacific J Trop Dis, 4(1): 40–4.
Bermawie, N., Purwiyanti, S. 2012. Botani, Sistematika dan Keragaman Kultivar Jahe. Balai
Penelitian Tanaman Obat dan Aromatik. (3), pp. 1–19.
Brennan dkk, 2008, Handbook of Anti-Tuberculosis Agents, Global Alliance for TB Drug
Development, 88 (2), 85-170.
Cheng, A.F., Yew, W.W., Chan, E.W., Chin, M.L., Hui, M.M., and Chan, R.C., 2004, Multiplex
PCR Amplimer Conformation Analysis for Rapid Detection of gyrA Mutations in
Fluoroquinolone-Resistant Mycobacterium tuberculosis Clinical Isolates, Antimicrob. Agents
Chemother, 48, 596–601.
Daryono, E. D. 2012. Ekstraksi Oleoresin dari Jahe dengan Variasi Jenis dan Konsentrasi Pelarut.
Institut Teknologi Nasional Malang. Jurnal Kimia. 3(3) : 271-284.
Departemen Kesehatan RI. 2011. Pedoman Nasional Pengendalian Tuberculosis. Jakarta. pp. 21-
29. Viewed 07 Februari 2018.
<http://med.unhas.ac.id/farmakologi/wp-content/uploads/2014/10/Pedoman-Nasional-
Penanggulangn-TB-2011.pdf>
DEPKES RI, 2007. Kebijakan Obat Tradisional Nasional: 26.
Depkes RI, 2005, Pharmaceutical Care, Direktorat Bina Farmasi Komunitas dan Klinik, Direktorat
Jenderal Bina Kefarmasian dan Alat Kesehatan Departemen Kesehatan RI, Jakarta
Dewoto, H.R., 2007. Pengembangan Obat Tradisional Indonesia Menjadi Fitofarmaka. Majalah
Kedokteran Indonesia, 57(7): 205–211.
Direktorat Bina Farmasi Komunitas Dan Klinik. 2005. Pharmaceutical Care Untuk Penyakit
Tuberkulosis. Jakarta: Departemen Kesehatan RI. pp. 41-58. Viewed 10 Desember 2017.
<http://binfar.depkes.go.id/dat/lama/1309242859_YANFAR.PC_TB_1.pdf>
Dorai T dan B.B. Aggarwal, 2004, Antitumor Promoting Activities of Selected Pungent Phenolic
Substances Present in Ginger, Cancer Lett, 215: 129-140.
Drlica K.; Hiasa H.; Kerns R.; Malik M.; Mustaev A.; Zhao X. (2009) Quinolones: Action and
resistance updated. Curr. Top. Med. Chem.9. 981–998. Viewed 21 Januari 2018.
< https://www.ncbi.nlm.nih.gov/pubmed/19747119>
Drlica K.; Malik M.; Kerns R. J.; Zhao X. (2008) Quinolone-mediated bacterial
death. Antimicrob. Agents Chemother. 52. 385–392. Viewed 21 Januari 2018. <
http://aac.asm.org/content/52/2/385.full >
Drlica, K., Malik M.; Kerns R. J.; Zhao X., 2003 Fluoroquinolones as Antituberculosis Agents. In:
Rom, W.N., Garay,S.M., (Ed.), Tuberculosis, 2nd Ed., 791-807, Philadelphia, PA: Lippincott
Williams & Wilkins
Ermayanti, T. M., Haflizh, E. A., Hapsari, B. W., Rudiyanto, & Rantau, D. E., 2009,
Penyederhanaan Media Kultur untuk Perbanyakan Bibit Jahe Merah Zingiber officinale Rosc
secara In Vitro, http://www.biotek.lipi.go.id/index.php/research-a-development/137-
research-2009/706-penyederhanaan-media-kultur-untuk-perbanyakan-bibit-jahe-merah-
zingiber-officinale-rosc-secara-in-vitro--dikti-2009.htm diakses April 2016
Fathona D, 2011, Kandungan Gingerol dan Shogaol, Intensitas Kepedasan dan Penerimaan
Panelis Terhadap Oleoresin Jahe Gajah (Zingiber Officinale Var. Roscoe), Jahe Emprit
(Zingiber Officinale Var. Amarum), dan Jahe Merah (Zingiber Officinale Var. Rubrum),
Institut Pertanian Bogor, http://repository.ipb.ac.id/handle/123456789/51192?show=full
diakses Maret 2016
Ficker, C., Smith, M.L., Akpagana, K., Gbeassor, M., Zhang, J., Durst, T., Assabgui, R.,
& Arnason, J.T., 2003, Bioassay-guided Isolation and Identification of Antifungal
Compounds from Ginger, Phytother, Res, 17: 897-902
Giriraju, A. and Yunus, G.Y., 2013. Assessment of antimicrobial potential of 10% ginger extract
against Streptococcus mutans, Candida albicans, and Enterococcus faecalis : An in vitro study.
Indian J. Dent. Res, 24(4): 397– 400.
Harini, M., D.A., Okid. 2009. Blood Cholesterol Level of Hypercholesterolemia Rat (Rattus
norvegicus) After VCO Treatment. Journal Bioscience Vol 1 No 2 : 53-58.
Harmono, A.Andoko, 2005, Budidaya dan Peluang Bisnis Jahe, Agromedia Pustaka, Jakarta
Hidayati, F., Agusmawanti, P. & Firdausy, M.D., 2015. Pengaruh Pemberian Ekstrak Jahe Merah
( Zingiber Officinale Var. Rubrum ) Terhadap Jumlah Sel Makrofag Ulkus Trauma Mukosa.
Odonto Dental Journal. 2(1): 51–57.
Jindani, A., Aber, V.R., Edwards, E.A. & Mitchison, .DA., 2002, The Early Bactericidal Activity
of Drugs in Patients with Pulmonary Tuberculosis, Am Rev Respir Dis., 121, 939–49.
Jun-hua. Z., Yu-guang. H. 2006. Immune system: a new look at pain. Chin Med J. 119. 930-938.
Viewed 14 Desember 2017. <https://www.ncbi.nlm.nih.gov/pubmed/16780773>
Jun-Ming Zhang. Jianxiong An. 2007. Cytokines. Inflammation and Pain. China. pp. 1-4. Viewed
14 Desember 2017.
< https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785020>
Kaplan LJ. 2017. Systemic Inflammatory Response Syndrome. Medscape. pp. 34-52. Viewed 02
Januari 2018.
Katzung, Bertram. 2010.Farmakologi dasar dan klinik. 10th ed. Jakarta : EGC. pp. 1171-1193.
Kementerian kesehatan RI. 2016. Infodatin : Tuberkulosis temukan obati sampai sembuh. Jakarta :
Kementerian Kesehatan RI. pp. 2-8. Viewed 10 Desember 2017.
<http://www.depkes.go.id/download.php?file=download/pusdatin/infodatin/InfoDatin-2016-
TB.pdf>
Kementerian Kesehatan RI. 2016. Profil Kesehatan Indonesia Tahun 2015. Jakarta : Kementerian
Kesehatan RI. Viewed 10 Desember 2017.
<http://www.depkes.go.id/resources/download/pusdatin/profil-kesehatan-indonesia/profil-
kesehatan-Indonesia-2015.pdf>
Kementerian kesehatan RI. 2014. Direktorat Jenderal Pengendalian Penyakit dan Penyehatan
Lingkungan. Pedoman nasional Pengendalian tuberkulosis. Jakarta : Kementerian Kesehatan
RI. pp. 13-20. Viewed 12 Desember 2017.
<http://www.tbindonesia.or.id/opendir/Buku/bpn_p-tb_2014.pdf>
Kementerian Kesehatan RI. 2015.Direktorat Jenderal Pengendalian Penyakit dan Penyehatan
Lingkungan. Buku saku pasien TB MDR.─ Jakarta : Kementerian Kesehatan RI. pp. 3-7.
Viewed 21 Januari 2018.
<http://kncv.or.id/images/xplod/publication/buku%20saku%20pasien%20tb-ro.pdf>
Kim, DS, DS Kim dan MN Oppel, 2005, Shogaols from Zingiber Officinale Protect IMR32 Human
Neuroblastoma and Normal Human Umbilical Vein Endothelial Cells from Beta-Amyloid (25-
35) Insult. Planta Med. 68: 375-376.
Kumar V, Abbas AK, Aster JC. Robbins and Cotran Pathologic Basis of Disease Ninth Edition.
Elsevier: 2015. pp. 157-205.
Kundu JK, Surh YJ. Inflammation: gearing the journey to cancer. Mutat. Res. 2008 Jul-
Aug;659(1-2):15-30.
Lu, T., Drlica, K., 2003, In vitro Activity of C-8-Methoxy Fluoroquinolones Against Mycobacteria
when Combined with Anti-Tuberculosis Agents, J Antimicrob Chemother, 52,1025-1028
Ma, Z., Ginsberg, A.M. & Spigelman, 2007, Antimycobacterium Agents, Global Alliance for TB
Drug Development, New York, USA
Mamoru, S., Ishige, A., Yuasa, K., Sudo, K., Aburada, M., Hosoya, E., 2000, Pharmacological
Studies on Ginger, I. Pharmacological Action of Pungent Constituents, 6-Gingerol and 6-
Shogaol, J. Pharmacobiol, Dyn 7: 836-848.
Masahiko Mihara, Misato Hashizume. 2012. IL-6/IL-6 receptor system and its role in
physiological and pathological conditions. pp. 143-146. Viewed 14 Desember 2017 .
<https://www.ncbi.nlm.nih.gov/pubmed/22029668>
Masuda Y., Kikuzaki, H., Hisamoto, M., Nakatani, N., 2004, Antioxidant properties of ginger
related compounds from ginger, Biofactors. 21: 293-296.
Mitchison, D., 2000, Role of Individual Drugs in The Chemotherapy of Tuberculosis, Int J Tuberc
Lung Dis, 4, 796-806
Mitchison, D., 2004, Antimicrobial Therapy of Tuberculosis: Justification for Currently
Recommended Treatment Regimens, Semin Respir Crit Care Med, 25, 307-315.
Munir SM, Nawas A, Soetoyo DK. 2010. Pengamatan pasien tuberkulosis paru dengan Multidrug
Resistant (TB-MDR) di Poliklinik Paru RSUP Persahabatan. pp. 92-104. Viewed 10
Desember 2017. <jurnalrespirologi.org/wp-content/uploads/.../92-104-APRIL-VOL_30-
NO_2-2010.pdf>
Oliviera, C. M. B., Sakata, R. K., Issy, A. M., Gerola, L. R. & Salomao, R. 2011. Cytokines and
pain. Rev Bras Anestesiol. 61. 255-26. Viewed 14 Desember 2017. <
https://www.ncbi.nlm.nih.gov/pubmed/21474032 >
Ozougwu, J.C., Elom M.O., Obimba K.C., Obiukwu C.E., Usanga V.U., 2016. Ameliorative
effects of Zingiber officinale extracts against experimentallyinduced hepatotoxicity in rats.
Am.-Eurasian J. Toxicol. Sci., 8(2): 69–76.
Pahwa R, Adams-Huet B, Jialal I. The effect of increasing body mass index on cardio-metabolic
risk and biomarkers of oxidative stress and inflammation in nascent metabolic syndrome. J.
Diabetes Complicat. 2017 May;31(5):810-813.
Pahwa R, Jialal I. Hyperglycemia Induces Toll-Like Receptor Activity Through Increased
Oxidative Stress. Metab Syndr Relat Disord. 2018 (5):239-41.
Paimin F B , Murhananto. 2008 . Seri Agribisnis Budi Daya Pengolahan, Perdagangan Jahe.
Jakarta : Penebar Swadaya.
Perhimpunan Dokter Paru Indonesia. 2006. Pedoman & penatalaksanaan tuberkulosis di
Indonesia. Jakarta : Perhimpunan Dokter Paru Indonesia. pp. 2-9. Viewed 12 Desember 2017.
< klikpdpi.com/konsensus/Xsip/tb.pd >
Perhimpunan Dokter Paru Indonesia. 2011. Pedoman Diagnosis dan Penatalaksanaan di Indonesia.
Revisi Pertama. Jakarta: Perhimpunan Dokter Paru Indonesia. p. 1-36. Viewed 12 Desember
2017,<https://www.scribd.com/document/360143741/262446069-Guideline-PPOK-
Lengkap-pdf>
Peloquin, C., Bulpitt, A,E., Jaresko, G,S., Jelliffe, R,W., Childs, J,M., Nix, D,E., 1999,
Pharmacokinetics of Ethambutol under Fasting Conditions, with Food, and with Antacids,
Antimicrob Agents Chemother, 43, 568-572.
Priyanti Z. Soepandi. 2010. Diagnosis Dan Penatalaksanaan Tb – MDR. Departemen Pulmonologi
Dan Ilmu Kedokteran Respirasi FKUI- RSUP Persahabatan : Jakarta. pp. 1-4. Viewed 12
Desember 2017. <www.kalbemed.com/Portals/6/07_180%20Diagnosis%20tbmdr.pdf>
Rahajoe NN, Basir D, Makmuri, Kartasasmita CB. 2008.Pedoman Nasional Tuberkulosis Anak .
Jakarta: UKK Respirologi PP IDAI. pp. 1-117.
Rahmani, A.H., Al Shabrmi, F.M. and Aly, S.M., 2014. Active ingredients of ginger as potential
candidates in the prevention and treatment of diseases via modulation of biological activities.
Int J Physiol Pathophysiol Pharmacol., 6(2): 125–36.
Restiani, K D., 2009, Uji Efek Sediaan Serbuk Instan Rimpang Jahe (Zingiber Officinale Roscoe)
sebagai Tonikum terhadap Mencit Jantan Galur Swiss Webster, Surakarta:Fakultas Farmasi
Universitas Muhammadiyah Surakarta
Reviono, P. Kusnanto. 2014.Multidrug Resistant Tuberculosis (MDR-TB): Tinjauan Epidemiologi
dan Faktor Risiko Efek Samping Obat Anti Tuberkulosis. Fakultas Kedokteran Universitas
Sebelas Maret Surakarta/ Rumah sakit Dr. Moewardi. volume 46 no. 4. pp. 189-191. Viewed
20 Desember 2017.
<http://journal.fk.unpad.ac.id/index.php/mkb/article/view/336>
Rose-John S. 2012. IL-6 Trans-Signaling via the Soluble IL-6 Receptor: Importance for the Pro-
Inflammatory Activities of IL-6. Int J Biol Sci. pp. 1238-1244. Viewed 23 Desember 2017.
<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491447>
Sembiring, S. , Sismudjito, 2015. Pengetahuan dan Pemanfaatan Metode Pengobatan pada
Masyarakat Desa Suka Nalu Kecamatan Barus Jahe. Jurnal Perspektif Sosiologi, 3(1): 104–
117.
Sherwood, Laurale. 2015. Fisiologi manusia : dari sel ke sistem. Jakarta :EGC. Alih bahasa oleh :
Brahm U. Pendit. pp. 448-450.
Singla, Rohit, Sharma, S,K., Mohan, A., Makharia, G., Sreenivas, V., Jha, B., Kumar, S., Sarda,
P., Singh, S., 2010. Evaluation of Risk Factor for Antituberculosis Treatment Indoced
Hepatotoxicity. Indian J Med Res., 132 : 81-86.
Somoskovi, A., Parsons, L.M. & Salfinger, M., 2001, The Molecular Basis of Resistance to
Isoniazid, Rifampin, and Pyrazinamide in Mycobacterium tuberculosis, Respir. Res., 2, 164–
168.
Stailova I, Krastanov A, Stoyanova A, 2007, Antioxidant Activity of Ginger Extract (Zingiber
officinale), Food Chemistry, 102:764-70
Stevani H, 2016, Praktikum Farmakologi, Jakarta : Kemenkes.
Sweetman, Sean C. 2005. Martindale The Complete Drug Reference. Edisi 34. London :
Pharmaceutical Press. pp. 1458-1460.
Syarif A., Estuningtyas A., Setiawati A., dkk. 2012. Farmakologi dan Terapi Ed. 5. Balai Penerbit
FK UI: Jakarta. pp. 613-731.
Tjay TH , Rahardja K. 2007. Obat-obat Penting. Jakarta: PT Elex Media Komputindo. pp. 365-
373.
Tjendraputra, E., Tran V.H., Liu-brennan D., Roufogalis B.D., Duke C.C., 2001. Effect of ginger
constituents and synthetic analogues on cyclooxygenase-2 enzyme in intact cells. Bioorg
Chem, 163(2001): 156–63.
Williams CA. , Lamprecht ED. 2008. Some commonly fed herbs and other functional foods in
equine nutrition: A review. The Veterinary Journal. 178: 21-31.
Wolfensohn S, Lloyd M. 2013. Handbook of Laboratory Animal Management and Welfare. Ed
ke-4. Chinchester (UK): John Wiley and Sons Ltd
World Health Organization, 2001, Guidelines for Drug Susceptibility Testing for Second-Line
Anti-Tuberculosis Drugs for DOTS-Plus.
World Health Organization, 2001, Involving Private Practitioners in Tuberculosis Control: Issues,
Interventions, and Emerging Policy Framework, Geneva, (WHO/CDS/TB/2001.285).
World Health Organization, 2001, WHO Global Strategy for Containment of Antimicrobial
Resistance, Geneva.
World Health Organization. 2013. Multidrug-resistant tuberculosis (MDR-TB) 2013 update. pp.
1-2. Viewed 07 Februari 2018.
< http://www.who.int/tb/challenges/mdr/MDR_TB_FactSheet.pdf>
World Health Organization. Global Tuberculosis Report 2017. World Health Organization.
Global tuberculosis report. 2017. Viewed 12 Desember 2017.
<http://apps.who.int/iris/bitstream/10665/259366/1/9789241565516-eng.pdf?ua=1>
World Health Organization. 2016 .Treatment guidelines for drug-resistant tuberculosis. 2016.
Viewed 12 Desember 2017.
<http://apps.who.int/iris/bitstream/10665/250125/1/9789241549639-eng.pdf>
Zhang, Y. , Mitchison, D., 2003, The Curious Characteristics of Pyrazinamide: a Review, Int. J.
Tuberc. Lung Dis., 7, 6–21.
Lampiran Surat Keterangan Lolos Uji Plagiasi FK UMM