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All Journal Medica Hospitalia The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Bantar Suntoko
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PERBEDAAN ANTARA PEMBERIAN EKSTRAK HERBAL (DAUN SALAM, JINTAN HITAM DAN DAUN SELEDRI) DENGAN ALLOPURINOL TERHADAP KADAR IL-6 DAN TNF SERUM PENDERITA HIPERURISEMIA Dwi Ngestiningsih; Ira Widiastuti; Tri Wahyu; Suyanto Hadi; Bantar Suntoko
Medica Hospitalia : Journal of Clinical Medicine Vol. 1 No. 1 (2012): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (256.847 KB) | DOI: 10.36408/mhjcm.v1i1.36

Abstract

Latar Belakang : Hiperurisemia akan memacu produksi sitokin proinflamasi TNF-±, IL-1 dan IL-6, yang akan memacu penarikan lekosit ke daerah deposit kristal monosodium urat dan melipatgandakan respon inflamasi. Daun salam (Eugenia polyantha), seledri (Apium graveolens) dan biji jinten hitam (Nigella sativa) dapat menurunkan respon inflamasi. Ketiga tanaman ini banyak di Indonesia namun sampai saat ini belum dilakukan uji klinik pada manusia. Tujuan penelitian adalah mengetahui apakah pemberian formula ekstrak herbal penurun asam urat dapat menurunkan kadar IL-6 dan TNF-± serum penderita hiperurisemia dibandingkan allopurinol. Metode: Desain penelitian adalah double blind randomised clinical trial (RCT), dilaksanakan Februari–Desember 2007. Subyek penelitian adalah penderita hiperurisemia usia ³ 18 tahun yang berobat di poliklinik/rawat inap penyakit dalam dan geriatri RSUP Dr. Kariadi Semarang. Sampel dibagi menjadi kelompok perlakuan dan kelola. Dilakukan pemeriksaan kadar IL-6 dan TNF-± serum dengan cara ELISA sebelum dan setelah 4 minggu perlakuan. Hasil: Sampel sebanyak 22 orang kelompok herbal dan 22 orang kelompok allopurinol. Rerata kadar IL-6 dan TNF-± awal kelompok herbal 214,58pg/dl dan 43,2 pg/dl sedangkan kelompok allopurinol 231,8pg/dl dan 32,6pg/dl. Rerata kadar IL-6 dan TNF-± akhir kelompok herbal 192,15 pg/dl dan 32,9pg/dl sedangkan kelompok allopurinol 203,8pg/dl dan 29,5pg/dl. Rerata delta kadar IL-6 dan TNF-α kelompok ekstrak herbal -22,43pg/dl dan -27,9pg/dl (p 0,887) sedangkan kelompok allopurinol 10,3pg/dl dan 3,10pg/dl (p 0,439). Kesimpulan: Ekstrak herbal penurun asam urat dapat menurunkan kadar IL-6 dan TNF-± serum penderita hiperurisemia, tidak berbeda bermakna dibandingkan dengan pemberian allopurinol. Kata kunci : IL-6, TNF-±, Eugenia polyantha, Apium graveolens, Nigella sativa
The Efficacy of Low Dose Captopril Adjuvant for Natriuresis in Patient with Liver Cirrhosis with Ascites Who Have Received Furosemide and Spironolacton Suyatmi Suyatmi; Bantar Suntoko; F. Sumanto; Hirlan Hirlan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 3, December 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2320011-5

Abstract

Background: The ideal therapy for ascites in liver cirrhosis is a low sodium diet and a combination of furosemide and spironolacton. However, this still sometimes does not produce satisfactory Results, even after increasing the dose of the diuretic. Such failure occurs due to the influence of the Renin Angiotensin Aldosterone (RAA) system. Low doses of ACE inhibitors (captopril) should improve renal blood flow and increase filtration at the glomeruli, thus increasing natriuresis without causing haemodynamic imbalance. Study aim: To discover the natriuretic and diuretic effects of low dose captopril adjuvant in patients with liver cirrhosis who have received furosemide and spironolacton by measuring urinary sodium and 24-hour urine output. Materials and method: This study was conducted on in- and out- patients with liver cirrhosis and Ascites at the Dr. Kariadi Central Public Hospital, Semarang, who met the inclusion and exclusion criteria. The study took place from June 1st, 1997 to March 31st, 1998, and included 40 cases of liver cirrhosis with ascites. Study design: Open comparative randomized clinical trial with permuted blocks. All of the patients received a low fat diet, 40 mg of furosemide, 3x50 mg of spironolacton for 2 weeks, and patients with a urinary sodium level was below 80 mEq/L were randomized into two groups: group A receiving 3 x 6.25 mg of captopril, and group B receiving standard therapy.  Results:  Variable            Pre- treatment       Post – treatment      p  Group A : Urinary sodium level (meq/L)   65.450 ± 16.577       109.950 ± 49.109     0.001 24-hour urine output (cc)     1138.750 ± 480.438     1381.250 ± 394.441    0.004 Group B: Urinary sodium level (meq/L)  68.30 ± 12.85         91.750 ± 64.04      0.103 24-hour urine output (cc)       1390 ± 448.27        1392.50 ± 713.46     0.988   The pre- and post- treatment Results for Group A were significantly different. The pre- and post- treatment Results for Group B were not significantly different. Conclusion: Low dose (3 x 6.25 mg) captopril adjuvant in patients with liver cirrhosis and ascites who have received standard doses of furosemide and spironolacton could increase natriuresis and diuresis without causing haemodynamic imbalance.    Key words: Captopril, liver cirrhosis, ascites
Co-Authors Dwi Ngestiningsih F. Sumanto Hirlan Hirlan Ira Widiastuti Suyanto Hadi Suyatmi Suyatmi Tri Wahyu