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Abstrak :
Tuberkulosis (TB) merupakan salah satu penyebab utama kesakitan dan kematian di dunia, dan Indonesia menempati peringkat ke-3 di dunia. Sambiloto (Andrographis paniculata Nees) merupakan salah satu tanaman yang terbukti dapat digunakan pada infeksi saluran nafas ringan, namun perannya pada pengobatan TB masih perlu diteliti. Penelitian ini dilakukan untuk membuktikan peran penambahan ekstrak sambiloto pada pasien TB paru kasus baru yang mendapat terapi standar. Penelitian ini merupakan uji klinis acak tersamar ganda (randomized double blind placebocontrolled clinical trial) terhadap 48 pasien TB paru kasus baru yang mendapat terapi standar Obat Anti Tuberkulosis (OAT). Pasien dibagi menjadi dua kelompok yang sama banyak, 24 pasien pada kelompok perlakuan mendapat ekstrak sambiloto 1x500mg perhari dan 24 pasien pada kelompok kontrol mendapat plasebo dan dinilai perbaikan klinis dan konversi sputum bakteri tahan asam (BTA) pada minggu ke 2, 4, 6 dan 8 serta pemeriksaan radiologis/foto thorak pada minggu 0 dan 8. Evaluasi 8 minggu pertama, pemberian ekstrak sambiloto pada pasien TB paru kasus baru yang mendapat terapi standar memberikan kecenderungan konversi lebih cepat dibandingkan pemberian plasebo, walaupun tidak didapatkan perbedaan bermakna secara statistik (rerata lama konversi sambiloto vs plasebo : 4,7 minggu vs 5,65 minggu; P = -0,026 (Uji P, Pearson Correlation ). Analisis subgrup konversi pada minggu ke-4 dan ke-6 memberikan hasil bermakna secara statistik (minggu ke 4 : plasebo : 43%; sambiloto 65%; minggu ke 6 : plasebo : 61%; sambiloto 70%). Didapatkan pula kecenderungan perbaikan gejala klinis dan perbaikan foto thorak dibandingkan plasebo walapun secara statistik tidak bermakna. Sambiloto cukup menjanjikan sebagai terapi komplementer pada pengobatan TB bersama dengan OAT, namun masih membutuhkan studi lebih banyak lagi.

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Tuberculosis (TB) is one of the major causes of morbidity and mortality in the world, and Indonesia ranks third in the world. Andrographis paniculata is one of the traditional plants that are proven to be used in mild respiratory tract infections, but its role in TB treatment remains to be investigated. This research was conducted to prove the role of the suplementation of extract Andrographis paniculata in patients with new cases of pulmonary TB who received standard therapy. This study is a randomized double-blind placebo-controlled clinical trial in 48 new cases of pulmonary TB patients who received standard therapy Anti Tuberculosis Agent, the patients were divided in two groups, in which group 1, 24 patients in the treatment group received the extract Andrographis paniculata 1x500mg per day and 24 patients in the control group received placebo and assessed clinical improvement and sputum smear conversion at weeks 0, 2, 4,6 and 8, and radiological examination / thoracic photo at weeks 0 and 8. Evaluation of the fist 8 weeks, the extract Andrographis paniculata in patients with new cases of pulmonary TB who received standard therapy provides faster conversion trend when compared with placebo, although the difference was not found statistically significant (mean old Andrographis paniculata conversion vs. placebo: 4.7 weeks vs. 5.65 weeks, P = -0.026 (P test, Pearson correlation). In this study, statistically not significant, but it has meant to the clinical improvement. Conversion analysis subgroup at 4 and 6 week, provide statistically significant results (in 4 week : placebo: 43%; bitter 65%, in 6 week : placebo : 61%; bitter 70%). Found also trend and the improvement of clinical symptom improvement compared to placebo thoracic photo even if it is not statistically significant. Andrographis paniculata enough promise as a complementary therapy in the treatment of TB along with OAT, but it still needs more study.

Abstrak :
[Pada penelitian ini, telah diuji pengaruh pemberian kombinasi ekstrak sambiloto (Andrographis paniculata Nees) dan spirulina (Arthrosphira platensis Gomont) terhadap persen parasitemia, persen survival, jumlah eritrosit dan kadar hemoglobin serta persen apoptosis sel limpa pada mencit yang diinfeksi P. berghei. Penelitian ini dilakukan dengan rancangan acak lengkap menggunakan 75 ekor mencit strain Swiss Webster. Kelompok uji terdiri dari kelompok AP, AP+ES, AP+PS, CMC dan DHP. Seluruh mencit diinfeksi Plasmodium berghei pada hari ke 0. Ekstrak bahan uji diberikan 3 hari sebelum diinfeksi (H-3) dan setiap hari selama 28 hari setelah infeksi. Data parasitemia diambil pada hari ke-3,7,10,15,21 dan 28. Sedangkan data jumlah eritrosit dan kadar Hb diambil pada hari ke 3, 10 dan 21. Pengolahan data dilakukan dengan uji Anova satu arah yang dilanjutkan dengan uji post hoc. Hasil penelitian menunjukkan bahwa kombinasi powder spirulina dan ekstrak sambiloto (AP+PS) memberikan hasil yang berbeda bermakna dalam menekan persen parasitemia (p=0,02), meningkatkan jumlah eritrosit (p=0,03) dan kadar hemoglobin (p=0,01) pada puncak infeksi, dibanding kelompok yang diberi sambiloto saja (AP). Pemberian ekstrak sambiloto dan atau tanpa spirulina dapat menurunkan persen apoptosis sel limpa secara bermakna (AP p= 0,001; AP+ES p= 0,000; AP+PS p= 0,000) dibanding dengan kelompok CMC pada puncak infeksi.;Effect of a combination of extracts of sambiloto (Andrographis paniculata Nees) and spirulina (Arthrosphira platensis Gomont) had been investigated decrease the number of parasitemia, increase erythrocytes count, level of hemoglobin and apoptosis of spleen cell in P. berghei infected mice. This study was conducted by employing a complete random design using 75 Swiss Webster mice. The test group consisted of groups of AP, AP + ES, AP + PS, DHP and CMC. All mice were infected with P. berghei on day 0. Material test given 3 days prior to infection (D-3) and for 28 consecutives days orally after infection. Data of parasitemia, taken on D3, 10,15, 21 and 28 while erythrocytes count, and level of hemoglobin taken on D3,10 and 21. Data processed by one way Anova test followed by post hoc test. Results showed that the combination of extract of sambiloto and spirulina powder (AP + PS) was significant in suppressing the number of parasitemia (p = 0.02), increase of erythrocytes (p = 0.03) and level of hemoglobin (p = 0.01) in the peak of infection, compared with the group given only sambiloto (AP). Combination of sambiloto extract and or without spirulina had been significant in decrease apoptosis of spleen cell, (AP p= 0,001; AP+ES p= 0,000; AP+PS p= 0,000) compared with group of CMC, Effect of a combination of extracts of sambiloto (Andrographis paniculata Nees) and spirulina (Arthrosphira platensis Gomont) had been investigated decrease the number of parasitemia, increase erythrocytes count, level of hemoglobin and apoptosis of spleen cell in P. berghei infected mice. This study was conducted by employing a complete random design using 75 Swiss Webster mice. The test group consisted of groups of AP, AP + ES, AP + PS, DHP and CMC. All mice were infected with P. berghei on day 0. Material test given 3 days prior to infection (D-3) and for 28 consecutives days orally after infection. Data of parasitemia, taken on D3, 10,15, 21 and 28 while erythrocytes count, and level of hemoglobin taken on D3,10 and 21. Data processed by one way Anova test followed by post hoc test. Results showed that the combination of extract of sambiloto and spirulina powder (AP + PS) was significant in suppressing the number of parasitemia (p = 0.02), increase of erythrocytes (p = 0.03) and level of hemoglobin (p = 0.01) in the peak of infection, compared with the group given only sambiloto (AP). Combination of sambiloto extract and or without spirulina had been significant in decrease apoptosis of spleen cell, (AP p= 0,001; AP+ES p= 0,000; AP+PS p= 0,000) compared with group of CMC]

Abstrak :
Diabetes melitus (DM) adalah penyakit metabolik yang ditandai dengan peningkatan kadar glukosa darah diatas normal (hiperglikemia). Bahan alami yang mengandung zat hipoglikemik dapat menjadi alternatif pengobatan DM, salah satunya adalah daun sambiloto (Andrographis paniculata). Daun sambiloto mengandung senyawa andrografolid dan flavonoid yang memiliki aktivitas anti-diabetes. Metode penelitian diawali dengan preparasi simplisia yang dilanjutkan dengan fermentasi menggunakan Aspergillus niger dengan variasi suhu fermentasi 26°C, 30°C, 34°C, dan 37°C. Sampel kemudian diekstraksi sonikasi pada frekuensi 42 kHz dengan pelarut etanol 70%. Dari keempat variasi suhu fermentasi, yield terbaik didapatkan pada suhu fermentasi 37°C dengan yield sebesar 14,85%. Hasil ekstraksi digunakan pada uji antidiabetes dengan membandingkan sampel yang diberi enzim α-glukosidase dengan variasi konsentrasi ekstrak kasar 100 ppm, 200 ppm, 300 ppm, 500 ppm, dan 5000 ppm dan dihitung absorbansinya menggunakan spektrofotometri UV-Vis. Rata-rata nilai inhibisi terbaik ditunjukkan pada ekstrak dengan suhu fermentasi 37°C. Analisis komponen kimia dilakukan menggunakan GC-MS dan didapatkan komponen terbanyak yaitu asam karboksilat dan asam dekanoat. Jumlah kedua komponen tersebut lebih banyak pada ekstrak terfermentasi dibandingkan dengan ekstrak tidak terfermentasi.

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Diabetes mellitus (DM) is a metabolic disease characterized by an increase in blood glucose levels above normal (hyperglycemia). Natural ingredients containing hypoglycemic substances can be an alternative treatment for DM, one of which is bitter leaf (Andrographis paniculata). Sambiloto leaves contain andrographolide and flavonoid compounds that have anti-diabetic activity. The research method began with simplicia preparation followed by fermentation using Aspergillus niger with variations in fermentation temperature of 26 ° C, 30 ° C, 34 ° C, and 37 ° C. The sample was then extracted with sonication at a frequency of 42 kHz with 70% ethanol solvent. Of the four fermentation temperature variations, the best yield is obtained at 37 ° C fermentation temperature with yields of 14.85%. Extraction results were used in antidiabetic tests by comparing samples given α-glucosidase enzymes with variations in crude extract concentrations of 100 ppm, 200 ppm, 300 ppm, 500 ppm, and 5000 ppm and the absorbance was calculated using UV-Vis spectrophotometry. Crude extract with fermentation in 37 ° C showed the biggest mean inhibition effect. Chemical component analysis was carried out using GC-MS and obtained the most components, namely carboxylic acid and dexoic acid. The amount of the two components is more in the fermented extract compared to the unfermented extract.

Abstrak :
Background: Use of Andrographis paniculata and Syzigium polyanthum have been sed widely, on the contrary the benefit and safety have not been scientifically proven. This study aimed to overviwe and analyze benefit and safety the extract of Andrographis paniculata and Syzigium polyanthum mixture to decrease blood glucose concentration. Methods: It was an experiment study among intervension and control group by a block random sampling with pre-post tesy design. Data were collected by questionnres and also data among interbension group, therapy of conventional antidiabetic of metformin in combination to the herbal extract of Andrographis paniculata and Syzigium polyanthum mixture (1:1) with among control group, of methformin. A total samples of 30 diabetes Melitus respondents were selected among males or females, aged 40-60 years with blood glucose concetration of 140-220 mg/dl, has no history of hypertension or has mild hypertension. the samples were deviced in 2 group composed of 15 person among intervsion and 15 person amon control groups, repectively. the interversion gruop was given metformin 500 mg once a day in the morning taken 15 minutesafter breakfest in combination to the extract of Andrographis paniculata and Syzigium polyanthum mixture (1:1) of 700 mg. The contrl group was given metformin 500 mg once a day in the morning taken 15 minutes after breakfast in combination to placebo. The duration of therapy was 4 weeks. Data were taken by anamnesa, physical diagnose, laboratory examination of fasting blood glucose and Oral Glucosa tolerance test (OGTT) in every week. Meanwhile for examination side effect on liver and run function test in every 2 (two) week. The data were analyzed descriptively and test. Results: Results showed that the intervention grop given metformin in combination to the extract of Andrographis paniculata and Syzigium polyanthum mixture (1:1) of 700 mg could significantly decrease fasting blood glucose but could not significantly decreaseOGTT in comprasion to control group given metformin with placebo. There were no side effects on liver and kidney function test in the theraphy of herbal extract of Andrographis paniculata and Syzigium polyanthum mixture in duration of 4 week. It concluded that the herbal of Andrographis paniculata and Syzigium polyanthum mixture is safe.