Electronic Theses and Dissertation

Hasil penelitian dinegara maju maupun negara berkembang telah terbukti kuat bahwa ASI menurunkan angka kejadian maupun derajat berbagai penyakit infeksi. Data saat ini menunjukkan bahwa meningkatkan pemberian ASI eksklusif hanya 37%. ASI ekskluif yaitu pemberian ASI saja tanpa makanan pendamping apapun mulai dari bayi baru lahir sampai usia enam bulan, apabila terjadi masalah menyusui dalam enam bulan ini maka akan menggangu proses pemberian ASI eksklusif. Masalah yang ditimbulkan dari mastitis dan rasa sakit yang terkait dengan kondisi tersebut umumnya terjadi pada 6-8 minggu setelah melahirkan dan ini telah terbukti berhubungan dengan penghentian menyusui secara dini, sehingga menjadi salah satu faktor pemicu terganggunya proses menyusui hingga 33%. Penyebab mastitis yaitu statis ASI dan infeksi, banyak faktor penyebab terjadinya statis ASI sehingga menjadi media pertumbuhan bakteri bila tidak diatasi secara efektif. Salah satu bakteri yang menyebabkan mastitis adalah Staphylococcus aureus. Beberapa penelitian eksperimen dan klinis mastitis telah menunjukkan bahwa pelepasan sitokin IL-6 sebagai penanda terjadinya inflamasi. Penatalaksanaan pada kasus mastitis umumnya dengan antibiotik, apabila digunakan secara berlebihan dapat menimbulkan resistensi terhadap bakteri, apalagi jika antibiotik harus diberikan dalam waktu jangka panjang. Pendekatan teurapeutik lain untuk penanganan mastitis yaitu dengan pengobatan herbal yang memiliki efek farmakologis yaitu menyerap panas, detoksifikasi, antiinflamasi dan antibakteri. Pemanfaatan tumbuhan herbal merupakan alternatif untuk mencegah dan mengobati penyakit, karena dianggap dapat mengurangi resistensi terhadap antibiotik, salah satunya untuk pengobatan mastitis. Beberapa tumbuhan yang berkhasiat obat yaitu daun mangkokan (Nothopanax scutellarium merr.), daun sirih (Piper betle Linn.) dan daun kelor (Moringa oliefera L.), yang tumbuh di pekarangan rumah.
Penelitian ini bertujuan untuk mengetahui efektifitas ekstrak etanol daun mangkokan, kelor dan sirih sebagai salah satu alternatif untuk anti radang pada mastitis. Penelitian dilakukan secara eksperimental dengan rancangan acak lengkap (RAL) terdiri dari lima kali ulangan, menggunakan kelinci betina lokal. Pengelompokan hewan coba dilakukan secara acak dengan membagi 25 kelinci menjadi 5 grup yaitu kontrol negatif, kontrol positif dan grup eksperimen 1, 2 dan 3, masing-masing kelompok berjumlah 5 kelinci. Grup kontrol negatif adalah grup kelinci laktasi 8 hari tanpa perlakuan apapun, grup kontrol positif adalah grup kelinci laktasi 8 hari model mastitis tanpa pemberian ekstrak, sedangkan grup eksperimen 1 yaitu kelinci laktasi 8 hari model mastitis yang akan diberikan ekstrak daun mangkokan, grup eksperimen 2 yaitu kelinci laktasi 8 hari model mastitis yang akan diberikan ekstrak daun kelor dan grup eksperimen 3 yaitu kelinci laktasi 8 hari model mastitis yang akan diberikan ekstrak daun sirih. Pemberian ekstrak secara oral dilakukan hari ke delapan setelah 4 jam injeksi S. aureus melalui sonde dengan dosis masing-masing ekstrak 50 mg/kgbb dengan frekuensi dua kali sehari selama lima hari berturut-turut, selanjutnya dikorbankan.
Penelitian dilakukan dalam lima tahapan penelitian. Tahapan pertama melakukan karakterisasi dan analisis fitokimia ekstrak etanol daun mangkokan, kelor dan sirih. Hasil uji fitokimia ekstrak etanol daun mangkokan, kelor dan sirih mengandung senyawa yang sama yaitu flavonoid, steroid, tannin, phenol, saponin dan alkaloid.
Tahapan kedua menganalisis senyawa aktif ekstrak mangkokan, kelor dan sirih menggunakan fourier transform infrared (FTIR). Hasil analisis FTIR menunjukkan bahwa ekstrak etanol daun N. scutellarium merr., M. oleifera Lam. dan P. betle mengkonfirmasi adanya gugus fungsi O-H, C-H, C=O, C=C, C-NO2, C-O-C dan (CH2)n. Tidak terdapat perbedaan gugus fungsi ekstrak etanol daun N. scutellarium, M. oleifera dan P. betle.
Tahapan ketiga mengukur dan menentukan daya hambat ekstrak daun mangkokan, kelor dan sirih terhadap S. aureus. Hasil pengukuran menunjukkan rerata daya hambat yang paling tertinggi hingga yang terendah adalah pada kelompok perlakuan amoxillin yakni sebesar 32,01 mm, kemudian dilanjutkan dengan kelompok perlakuan khlorapenicol sebesar 26.82, daun sirih 100% sebesar 21,29 mm, daun sirih 80% sebesar 19,24 mm, daun sirih 60% sebesar 18,16 mm, vancomisin sebesar 16,56 mm, daun sirih 40% sebesar 15,80 mm, daun mangkokan 100% sebesar 13,47 mm, daun sirih 20% sebesar 13,38 mm, daun mangkokan 80% sebesar 11,82 mm, daun mangkokan 60% sebesar 10,92 mm, daun mangkokan 40% sebesar 9,73 mm, daun kelor 100% sebesar 8,02 mm, daun mangkokan 20% sebesar 7,10 mm, daun kelor sebesar 80% 6,98 mm, daun kelor 60% sebesar 6,63 mm, daun kelor 40% sebesar 6,55 mm, dan yang paling teredah pada daun kelor 20% sebesar 6,08 mm. Hasil uji analisis statistik pengaruh ekstrak daun mangkokan, kelor dan sirih terhadap daya hambat dapat menunjukkan nilai rata-rata yang berbeda nyata (p

Research results in both developed and developing countries have proven strongly that breastfeeding reduces the incidence and degree of various infectious diseases. Current data shows that exclusive breastfeeding is increasing by only 37%. Exclusive breastfeeding, namely breastfeeding alone without any complementary foods, starts from newborns to six months of age. If there are problems with breastfeeding in these six months, it will interfere with the process of exclusive breastfeeding. Problems arising from mastitis and the pain associated with this condition generally occur 6–8 weeks after delivery, and this has been shown to be associated with early cessation of breastfeeding, thus being one of the triggering factors for interruption of the breastfeeding process by up to 33%. The causes of mastitis are breast milk stasis and infection. There are many factors that cause breast milk stasis, which becomes a medium for bacterial growth if not treated effectively. One of the bacteria that causes mastitis is Staphylococcus aureus. A number of experimental and clinical studies of mastitis have shown that the release of the cytokine IL-6 is a marker of inflammation. Management of mastitis cases is generally with antibiotics; if used excessively, they can cause resistance to bacteria, and antibiotics must be given in the long term. Another therapeutic approach for treating mastitis is herbal treatment, which has pharmacological effects, namely heat-absorbing, detoxifying, anti-inflammatory, and antibacterial. Utilization of herbal plants is an alternative to preventing and treating disease because they are considered to reduce resistance to antibiotics, one of which is for the treatment of mastitis. Some plants that have medicinal properties are Nothopanax scutellarium merr. (N. scutellarium), Moringa oliefera L. (M. oleifera), Piper betle Linn. (P. betle), and their leaves, which grow in the yard of the house. This study aims to determine the effectiveness of the ethanol extract of N. scutellarium, M. oleifera, and P. betle leaves as an alternative for anti-inflammation in mastitis. The study was conducted experimentally with a completely randomized design consisting of five replications using local rabbits. The grouping of experimental animals was done randomly by dividing 25 rabbits into 5 groups, namely negative control, positive control, experimental groups 1, 2, and 3, each group consisting of 5 rabbits. The negative control group was the 8-day lactation rabbit group without any treatment, the positive control group was the 8-day lactation mastitis model rabbit group without giving extracts, while experimental group 1 was the 8-day lactation rabbit mastitis model that would be given N. scutellarium leaf extract, the second experimental group was 8-day lactation mastitis model rabbits that would be given M. oleifera leaf extract, and experimental group 3 was 8-day lactation mastitis model rabbits model rabbits model rabbits model rabbits model rabbits model rabbits model rabbits that would P. betle extract. Oral administration of the extract was carried out on the eighth day after 4 hours of injection of S. aureus through a sonde with a dose of 50 mg/kg/bb of each extract twice a day for five consecutive days, then sacrificed. The research was conducted in five stages. The first stage was to characterize and analyze the phytochemicals of the ethanol extracts of N. scutellarium, M. oleifera, and P. betle leaves. The results of the phytochemical test of the ethanol extracts of N. scutellarium, M. oleifera, and P. betle leaves contain the same compounds, namely flavonoids, steroids, tannins, phenols, saponins, and alkaloids. The second stage analyzed the active compounds of N. scutellarium, M. oleifera, and P. betle extracts using Fourier transform infrared (FTIR). The results of FTIR analysis showed that the ethanol extract of the leaves of N. scutellarium, M. oleifera, and P. betle confirmed the presence of functional groups O-H, C-H, C=O, C=C, C-NO2, C-O-C, and (CH2)n. There were no differences in the functional groups of the ethanol extract of the leaves of N. scutellarium, M. oleifera, and P. betle. The third stage measured and determined the inhibition of N. scutellarium, M. oleifera, and P. betle leaf extracts against S. aureus. The measurement results showed that the average inhibition from the highest to the lowest was in the amoxicillin treatment group, which was 32.01 mm, then continued with the chlorapenicol treatment group, which was 26.82 mm.100% P. betel leaf, 21.29 mm; 80% P. betle leaf, 19.24 mm; 60% P. betle leaf, 18.16 mm; vancomycin, 16.56 mm; 40% P. betle leaf, 15.80 mm; 100% N. scutellarium leaf, 13.47 mm; 20% P. betle leaf, 13.38 mm; 80% N. scutellarium leaves, 11.82 mm; 60% N. scutellarium leaves, 10.92 mm; 40% N. scutellarium leaves, 9.73 mm; 100% M. oleifera leaves, 8.02 mm; 20% N. scutellarium leaves, by 7.10 mm; 80% M. oleifera leaves, 6.98 mm; 60% M. oleifera leaves 6.63 mm, 40% M. oleifera leaves 6.55 mm, and the lowest at 20% M. oleifera leaves 6.08 mm. The results of statistical analysis tests on the effect of N. scutellarium, M. oleifera, and P. betle leaf extracts on inhibition showed significantly different average values (p