i

KARYA TULIS AKHIR

PENGARUH PEMBERIAN EKSTRAK STRAWBERRY

(FRAGARIA X ANANASSA VAR DUCHESNE) SEBAGAI ANTIINFLAMASI

PADA TIKUS PUTIH STRAIN WISTAR (RATTUS NOVERGICUS)

YANG DIINDUKSI KARAGENAN 1%

Oleh :

DEVI DEWANTI

201010330311023

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2015

ii

HASIL PENELITIAN

PENGARUH PEMBERIAN EKSTRAK STRAWBERRY

(FRAGARIA X ANANASSA VAR DUCHESNE) SEBAGAI ANTIINFLAMASI

PADA TIKUS PUTIH STRAIN WISTAR (RATTUS NOVERGICUS)

YANG DIINDUKSI KARAGENAN 1%

KARYA TULIS AKHIR

Diajukan kepada

Universitas Muhammadiyah Malang untuk memenuhi

salah satu persyaratan dalam menyelesaikan

Program Sarjana Fakultas Kedokteran

Oleh :

DEVI DEWANTI

201010330311023

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2015

iii

LEMBAR PENGESAHAN

LAPORAN HASIL PENELITIAN

Telah disetujui sebagai hasil penelitian

untuk memenuhi persyaratan

Pendidikan Sarjana Fakultas Kedokteran

Universitas Muhammadiyah Malang

Tanggal : 17 Februari 2015

Pembimbing I

dr. Fathiyah Safithri, M.Kes

Pembimbing II

dr. Gita Sekar Prihanti, MPdKed

Mengetahui,

Fakultas Kedokteran Universitas Muhammadiyah Malang

Dekan,

Dr. Irma Suswati, M.Kes

iv

LEMBAR PENGUJIAN

Karya Tulis Akhir oleh Devi Dewanti

telah di uji dan dipertahankan di depan Tim Penguji

pada tanggal 17 Februari 2015

Tim Penguji

dr. Fathiyah Safithri, M.Kes , Ketua

dr. Sri Adila Nurainiwati Sp.KK , Anggota

dr. Gita Sekar Prihanti, MPdKed , Anggota

v

KATA PENGANTAR

Puji syukur kehadirat Allah SWT atas kasih dan cinta-Nya sehingga penulisan

tugas akhir yang berjudul “Pengaruh Pemberian Ekstrak Strawberry (Fragaria X

Ananassa Var Duchesne) Sebagai Antiinflamasi Pada Tikus Putih Strain Wistar

(Rattus Novergicus) Yang Diinduksi Karagenan 1%” ini dapat diselesaikan dengan

baik. Tugas akhir ini diajukan untuk memenuhi persyaratan Pendidikan Sarjana

Fakultas Kedokteran Universitas Muhammadiyah Malang.

Pada kesempatan ini, penulis menyampaikan terima kasih kepada :

1. Allah SWT, Berkat rahmat dan petunjuk-Nya sehingga penulis dapat

menyelesaikan tugas akhir ini.

2. dr. Irma Suswati, M.Kes., selaku dekan Fakultas Kedokteran Universitas

Muhammadiyah Malang atas bimbingannya selama di FK-UMM.

3. dr. Fathiyah Safithri, M.Kes., selaku pembimbing I, atas bimbingan dan

kesabarannya sehingga penulis dapat menyelesaikan penelitian ini dengan

baik.

4. dr. Gita Sekar Prihanti, MPdKed, selaku pembimbing II, atas bimbingan

dan semangatnya sehingga penulis dapat menyelesaikan penelitian ini

dengan baik.

5. dr. Sri Adila Nurainiwati Sp.KK, selaku penguji tugas akhir ini, atas

masukan-masukannya yang sangat membantu dalam penyelesaian tugas

akhir ini.

vi

6. H.Pitoyo dan Hj. Rusmiyati, selaku orang tua penulis yang telah bekerja

keras untuk memberikan semua yang terbaik, dan selalu memberikan doa,

mengarahkan, membimbing, serta memberikan semangat kepada penulis

sehingga bisa menyelesaikan tugas akhir ini.

7. drg. Lia Puspita selaku kakak penulis, terima kasih atas doa, semangat,

saran, dan idenya dalam membantu kelancaran tugas akhir ini.

8. Tantia Devi Iralawati, Farahiya Nabila, Fika Taslim, Intan Ayu Islami,

Iwana Anni Rakhmawati, Rezky Ami Cahyaharnita, selaku sahabat terbaik

dan orang terdekat yang selalu setia menemani, memberi semangat, dan

membantu memperbaiki kekurangan dalam setiap proses pengerjaan tugas

akhir ini dan teman-teman FK UMM 2010 lainnya.

9. Kakak-kakak 2008 dan 2009, adik-adik 2011 dan 2012 dan teman-teman

BEM FK UMM 2010.

10. Mas Miftah, Pak Kus, dan tim laboratorium biomedik lainnya, tim

laboratorium skill, serta para staff dan karyawan TU.

11. Pak Yono, Bu Endah, Mas Didit, Mbak Citra, Mbak Nuke, selaku pegawai

TU FK UMM yang telah membantu dalam setiap proses demi kelancaran

pengerjaan tugas akhir ini.

12. Semua pihak yang terlibat langsung maupun tidak langsung yang tidak

mampu penulis sebutkan satu-persatu.

Penulis menyadari bahwa tugas akhir ini masih belum sempurna, untuk itu

penulis mengharapkan kritik dan saran yang membangun. Semoga karya tulis ini

dapat bermanfaat.

Malang, Februari 2015

Penulis

vii

ABSTRAK

Dewanti, Devi. 2015, Efek Anti Inflamasi Ekstrak Strawberry (Fragaria x ananassa

Duchesne) terhadap Tikus Strain Wistar (Rattus Novergicus) yang Diinjeksi

Karagenan 1%, Tugas Akhir, Fakultas Kedokteran Universitas

Muhammadiyah Malang. Pembimbing: (1) Fathiyah Safithri*), (2) Gita Sekar

Prihanti**).

Latar Belakang : Inflamasi merupakan respon protektif untuk menyingkirkan stimulus

berbahaya. Untuk mengobati inflamasi biasa digunakan obat golongan NSAID yang

memiliki efek samping merugikan bagi pasien. Strawberry mengandung flavonoid yang

dapat menghambat aktivitas enzim cyclooxygenase, sehingga dapat mengurangi dan

menurunkan inflamasi.

Tujuan : Untuk membuktikan ekstrak strawberry (Fragaria x ananassa Duchesne)

berpengaruh sebagai anti inflamasi terhadap tikus strain wistar (Rattus novergicus) yang

diinjeksi karagenan 1%.

Metode : Penelitian eksperimental dengan The Pre and Post Test Control Group

Design, menggunakan 4 kelompok: (1) kontrol positif, (2) perlakuan dosis 150

mg/kgBB, (3) perlakuan dosis 300 mg/kgBB, dan (4) perlakuan dosis 450

mg/kgBB. Analisis data menggunakan uji normalitas, homogenitas, uji korelasi

regresi, HSD Tukey 5% dan One Way ANOVA

Hasil dan Diskusi : Uji One Way ANOVA pada jam ke-3 didapatkan nillai sig = 0,005

(p<0,05), terdapat pengaruh bermakna pada ekstrak strawberry terhadap penurunan

volume edema. Hal ini diduga karena kandungan flavonoid yang menghambat dapat

menghambat aktivitas enzim cyclooxygenase sehingga dapat menurunkan inflamasi.

Dosis ekstrak strawberry yang memberikan efek anti inflamasi paling besar pada

penelitian ini adalah 450 mg/kgBB. Uji regresi linier menunjukkan ekstrak strawberry

berpengaruh 46,4% terhadap inflamasi.

Kesimpulan : Ekstrak strawberry memberikan efek anti inflamasi terhadap tikus strain

wistar yang diinjeksi karagenan.

Kata kunci: Ekstrak strawberry, inflamasi, penurunan volume edema.

*) : Staff Pengajar Fakultas Kedokteran UMM

**) : Staff Pengajar Fakultas Kedokteran UMM

viii

ABSTRACT

Dewanti, Devi. 2015, Anti Inflammatory Effect of Strawberry Extract (Fragaria x

ananassa Duchesne) to Carrageenan Injected Strain Wistar Rats (Rattus

novergicus) . Final Assignment, Faculty of Medicine University of

Muhammadiyah Malang. Supervisors: (1) Fathiyah Safithri*), (2) Gita Sekar

Prihanti **).

Background : Inflammation is a protective response of the harmful stimulus. To reduce

inflammation, people used NSAID which caused many adverse effect. Strawberry

contains flavonoid which can inhibit cyclooxygenase enzym, so can reduce inflammation.

Objective : To explore out that strawberry extract take anti inflammatory effect to

carrageenan injected strain wistar rats.

Method : This study was an experimental study with the Pre and Post Test Control Group

Design and using 4 groups: (1) control, (2) treatment dose of 150 mg / kg, (3) treatment

dose of 300 mg / kg, and (4) treatment dose of 450 mg / kg. Data analysis was using

normality, homogeneity test, correlation and linear regression, Tukey HSD 5% and One-

Way ANOVA.

Result and Discussion : One Way ANOVA test on the third hour (ANOVA p <0.05)

with a significance of 0.005. It may cause by strawberry contains flavonoid which can

inhibit cyclooxygenase enzym so can reduce inflammation. Optimum dose of strawberry

extract as anti inflammatory is 450 mg/kgBB. Linear regresion test showed that

strawberry extract take 46,4% anti inflammatory effect.

Conclusion : Strawberry extract may take anti inflammatory effect to carrageenan

injected strain wistar rats.

Keyword: Strawberry extract, inflammation, inflammatory reduction percentage.

*) : Lecturer Department of Medical Faculty, UMM

**) : Lecturer Department of Medical Faculty, UMM

ix

DAFTAR ISI

Halaman

JUDUL ....................................................................................................................i

HALAMAN JUDUL ............................................................................................... ii

LEMBAR PENGESAHAN ................................................................................... iii

LEMBAR PENGUJIAN ........................................................................................ iv

KATA PENGANTAR ............................................................................................ v

ABSTRAK ............................................................................................................ vii

ABSTRACT .......................................................................................................... vii

DAFTAR ISI ......................................................................................................... ix

DAFTAR TABEL ................................................................................................ xii

DAFTAR GAMBAR .......................................................................................... xiii

DAFTAR SINGKATAN .................................................................................... xiv

DAFTAR LAMPIRAN ........................................................................................ xv

BAB 1 PENDAHULUAN ...................................................................................... 1

1.1 Latar Belakang ........................................................................................ 1

1.2 Rumusan Masalah................................................................................... 3

1.3 Tujuan Penelitian .................................................................................... 3

1.3.1 Tujuan Umum ............................................................................... 4

1.3.2 Tujuan Khusus .............................................................................. 4

1.4 Manfaat Penelitian ................................................................................... 4

1.4.1 Manfaat Akademis ........................................................................ 4

1.4.2 Manfaat Klinis ............................................................................... 4

BAB 2 TINJAUAN PUSTAKA ............................................................................. 5

2.1 Strawberry ............................................................................................... 5

2.1.1 Taksonomi Buah Strawberry ........................................................ 5

2.1.2 Morfologi Buah Strawberry .......................................................... 6

2.1.3 Kandungan Strawberry.................................................................. 8

2.2 Inflamasi Akut ...................................................................................... 14

2.2.1 Definisi Inflamasi Akut ............................................................... 14

2.2.2 Patofisiologi Inflamasi ................................................................ 15

2.2.3 Mediator Inflamasi ...................................................................... 18

x

2.2.4 Manifestasi Klinis Inflamasi akut ............................................... 19

2.3 Karagenan ............................................................................................. 20

2.3.1 Definisi Karagenan...................................................................... 20

2.3.2 Mekanisme Karagenan sebagai Penginduksi Inflamasi .............. 21

BAB 3 KERANGKA KONSEP DAN HIPOTESIS PENELITIAN .................... 22

3.1 Kerangka Konsep ................................................................................. 22

3.2 Hipotesis Penelitian .............................................................................. 23

BAB 4 METODE PENELITIAN.......................................................................... 24

4.1 Rancangan Penelitian ........................................................................... 24

4.2 Tempat dan Waktu Penelitian ............................................................... 24

4.3 Populasi dan Sampel Penelitian ............................................................ 24

4.3.1 Populasi Penelitian ................................................................... 24

4.3.2 Sampel Penelitian .................................................................... 24

4.3.3 Teknik Sampling ...................................................................... 24

4.3.4 Estimasi Besar Sampel ............................................................. 25

4.3.5 Kriteria Sampel Penelitian ....................................................... 25

4.3.5.1 Kriteria Inklusi ............................................................ 25

4.3.5.2 Kriteria Eksklusi .......................................................... 26

4.3.6 Variabel Penelitian ................................................................... 26

4.3.6.1 Variabel Bebas ............................................................ 26

4.3.6.2 Variabel Tergantung .................................................... 26

4.3.7 Definisi Operasional ................................................................ 26

4.4 Alat dan Bahan Penelitian .................................................................... 27

4.4.1 Alat ........................................................................................... 27

4.4.2 Bahan ....................................................................................... 28

4.5 Prosedur Penelitian ............................................................................... 28

4.5.1 Dasar Penentuan Dosis Ekstrak Strawberry ............................ 28

4.5.2 Pembagian Kelompok Tikus .................................................... 28

4.5.3 Adaptasi Hewan Coba ............................................................. 29

4.5.4 Induksi Karagenan ................................................................... 29

4.5.5 Pemberian Ekstrak Strawberry ............................................... 29

4.5.6 Pembuatan Ekstrak Strawberry ............................................... 30

xi

4.5.7 Pembuatan Larutan Karagenan 1% ......................................... 31

4.5.8 Prosedur Pelaksanaan dan Pengumpulan Data ....................... 31

4.6 Alur Penelitian ...................................................................................... 33

4.7 Analisis Data......................................................................................... 34

BAB 5 HASIL DAN ANALISIS DATA PENELITIAN ..................................... 35

5.1 Hasil Penelitian ..................................................................................... 35

5.2 Analisis Data Penelitian ........................................................................ 38

BAB 6 PEMBAHASAN ....................................................................................... 43

BAB 7 KESIMPULAN DAN SARAN ................................................................ 45

7.1 Kesimpulan ........................................................................................... 45

7.2 Saran ..................................................................................................... 45

DAFTAR PUSTAKA ........................................................................................... 46

LAMPIRAN .......................................................................................................... 50

xii

DAFTAR TABEL

Halaman

Tabel 2.1 Kandungan Nutrisi Strawberry .............................................................. 8

Tabel 2.2 Kandungan Asam Amino Strawberry ..................................................... 8

Tabel 2.3 Kandungan Mineral Strawberry .............................................................. 9

Tabel 2.4 Kandungan Vitamin Strawberry ............................................................. 9

Tabel 2.5 Kandungan Flavonoid Strawberry .......................................................... 9

xiii

DAFTAR GAMBAR

Halaman

Gambar 2.1 Strawberry (Fragaria x Ananassa Var Duchesne) .............................. 6

Gambar 2.2 Rumus Bangun Kimia Flavonoid ...................................................... 10

Gambar 2.3 Rumus Bangun Kimia Antosianin .................................................... 11

xiv

DAFTAR SINGKATAN

C/EBP : CCAAT/Enhancer-Binding Protein

CAT : Catalase

COX : Cyclooxygenase

COX-1 : Cyclooxygenase-1

COX-2 : Cyclooxygenase-2

Na : Natrium

NF-κB : Nuclear Factor-kappa B

NO : Nitrite Oxide

TNF : Tumor Necrosis Factor- α

IL-1 : Interleukin 1

PG : Prostaglandin

PGI1 : Prostasiklin

PGE2 : Prostaglandin E2

xv

DAFTAR LAMPIRAN

Lampiran Halaman

Lampiran 1: Hasil Penelitian Pendahuluan ............................................. 50

Lampiran 2: Data Hasil Penelitian .......................................................... 52

Lampiran 3: Tabel Konversi Dosis..........................................................55

Lampiran 4: Analisis Data ...................................................................... 56

Lampiran 5: Dokumentasi Penelitian ...................................................... 66

Lampiran 6: Determinasi Tanaman Strawberry ...................................... 68

Lampiran 7: Surat Keterangan Penelitian ............................................... 69

Lampiran 8: Kartu Konsultasi Tugas Akhir.............................................70

xvi

DAFTAR PUSTAKA

Amanlou, M., F. Dadkhah, A. Salehnia, H. Farsam, and A.R. Dehpour. 2005. An

antiinflammatory and anti nociceptive effects of hydroalcoholic extract of

Satureja khuzistanica Jamzad extract. Journal Pharmacology and

Pharmaceutical Science 8 (1): 102-106.

Ammar, N.M., S.Y. Al-Okbi, and D.A. Muhamed. 2005. Study of the anti-

inflammatory activity of some medical edible plants growing in Egypt.

Journal of Islamic Academy of Sciences 10 (4).

Baratawidjaja, K.G et al. 2010. Imunologi Dasar Edisi 9. Jakarta: Fakultas

Kedokteran Universitas Indonesia

Battino M, Beekwilder J, Denoyes-Rothan B, Laimer M, McDougall G J and

Mezzetti B. 2009. Bioactive compounds in berries relevant to human

health, Nutrition Reviews 67 (1), pp.145-150.

Corwin J. Elizabeth, 2008. Handbook of Pathophysiology 3th edition.

Philadelphia: Lippincort Williams & Wilkins, 138-143.

Corsini, E., Paola R. D.,Viviani, B., Genovese, T., Mazzon, E., Lucchi, L., Galli,

C.L., and Cuzzorcrea S. 2005. Increased Carragenan-Induced Acute Lung

Inflamation in Old Rats,Immunology,115(2):253-261.

Dannhardt, G and Laufer, S., Cyclooxxygenase inhibitors-current status and

future prospects. 2000. Eur. J.Med.Chem.,7, 1101-1112.

Distantina Sperisa, Fadilah, Rochmadi, Moh. Fahrurrozi, , 2010, Proses

Ekstraksi Karagenan dari Eucheuma cottonii, Seminar Rekayasa Kimia

dan Proses.

Dorland. Kamus Saku Kedokteran Dorland. Edisi 25. Alih Bahasa dr. Poppy

Kumala, dr Sugiarto Kumala, dr Alexander H.Santoso, dr Johannes

Rubijanto Sulaiman, dr Yuliasari Rienita. Jakarta : Penerbit Buku

Kedokteran EGC, 1998.

Fitriyani, Atik., Lina Winarti, Siti Muslichah, dan Nuri. 2011. Uji Antiinflamasi

Ekstrak Metanol Daun Sirih Merah (Piper crocatum Ruiz & Pav) pada

Tikus Putih, 16 (1), 34-42

Fransen M, Bridgett L, March L et al, 2011. The Epidemiology of Osteoarthritis

in Asia International Journal of Rheumatic Disease, Vol.14 pp 113-121

Gunawan, D dan Mulyani, S. 2004. Ilmu Obat Alam (Farmakognisi). Jilid 1.

Jakarta : Penebar Swadaya

Hellman DB, Stone JH; Arthtritis and musculoskeletal disorder. In : McPhee ST,

Papadakis MA (editor). Current Diagnosis & Treatment 2007. Mc Graw-

xvii

Hill, 2007. In : Katzung, B. G. 2002. Farmakologi Dasar dan Klinik.

diterjemahkan oleh Dripa, S. 449-471. Salemba Medika, Jakarta.

Hidayati, Nur Annis., Shanti Listyawati, dan Ahmad Dwi Setyawan. 2008.

Kandungan Kimia dan Uji Antiinflamasi Ekstrak Etanol Lantana camara

L. pada Tikus Putih (Rattus norvegicus L.) Jantan. Bioteknologi 5 (1): 10-

17, ISSN : 0216-6887

Imeson, A.P. 2009. Handbook of Hydrocolloids: Carrageenan. UK: Woodhead

Publishing. (5): 91-93.

Jakobek, Lidija, Seruga, Marijan, Kosanovic, Martina and Novak, Ivana. 2007.

Anthocyanin contents and antioxidant activity of various red fruit juices.

Department of Applied Chemistry and Ecology, Faculty of Food

Technology, .J.J Strossmayer Unisversity of Osijek, Kuhaceva. Croatia

Jeong, Woo. Lee, Sup. Shin, Chul Sung. Kim, Young. 2013. Anthocyanins

Downregulate Lipopolysaccharide-Induced Inflammatory Responses in

BV2 Microglial Cells by Suppressing the NF-κB and Akt/MAPKs Signaling

Pathways. International Journal of Molecular Sciences 1502-1515.

Jill M. Tall, Navindra P. Seeram, Chengshui Zhao, Muraleedharan G. Nair,

Richard A. Meyer, Srinivasa N. Raja. 2004. Tart cherry anthocyanins

suppress inflammation-induced pain behavior in rat (Abstract).

Behavioural Brain Research 153: 181–188.

Kirsten, A. 2013. Chapter 6 Strawberry in The Mid-Atlantic Berry Guide for

Commercial Growers 2013-2014. page 49-112. College of Agricultural

Science Departement of Horticulture Penn State. United States.

Lafuente, Garcia-Ana. Guillamon, Eva. Villares, Ana. Rostagno A Mauricio.

Martinez, Alfredo Jose. 2009. Flavonoids as anti-inflammatory agents:

implications in cancer and cardiovascular disease

B r Verlag,

Basel/Switzerland

Lawrence, T, Willoughby, DA & G , DW , ‘Anti-Inflammatory Lipid

Mediators and Insight into the resolution of inflammation’, Nature

Reviews Immunology vol. 2, pp787-795

Lelo, A. dan D. S. Hidayat, 2004, Penggunaan Antiinflamasi Non Steroid yang

Rasional pada penanggulangan Nyeri Reumatik. Fakultas Kedokteran

Bagian Farmakologi dan Terapeutik Universitas Sumatera Utara

Miguell, MG. 2011. Anthocyanins: Antioxidant and/or anti-inflammatory

activities. Journal of Applied Pharmaceutical Science. Available online at

www.japsonline.com. Faculdade de Ciências e Tecnologia, Departamento

de Química e Farmácia, Centro de Biotecnologia Vegetal, Instituto de

Biotecnologia e Bioengenharia, Universidade do Algarve, Campus de

Gambelas, 8005- 139 Faro, Portugal

xviii

Morris, Christoper J. 2003. Carrageenan-Induced Paw in the Rat and Mouse. In

P.G. Winyard and D.A Willoughby (Ed.). Methods in Molecular Biology,

Vol. 225: Inflammation Protocols (pp. 115-121). Totowa, NJ: Humana

Press Inc.

Mueller, J. 2005. Bioflavonoids: Natural Relief for Allergies and Asthma.

www.worldwidehealthcenter.net/articles- 336.html

Muralidhar, K. Babu, Sudhakar. Sankar, Ravi. Reddanna, P. Reddy, G. Latha, J.

2010. Anti inflammatory activity of flavonoid fraction isolated from the

stem bark of Butea Monosperma (lam) : a mechanism based study.

International Journal of Phytopharmacology. Department of Chemistry, Sri

Krishnadevaraya University, Anantapur, Andhra Pradesh, India

Necas L, L. Bartosikova, 2013, Carageenan, Veterinarni Medicina, pp. 187-205.

Patel, Mitul., Murugananthan, dan Shivalinge Gowda K,P. 2012. In Vivo Animal

Models in Preclinical Evaluation of Anti-Inflammatory Activity- A Review.

International Journal of Pharmaceutical Research & Allied Sciences, Vol.

1 : 01-05, ISSN 2277-3657

Pearson, et al. 2005. Flavanols and Platelet Reactivity. Clinical & Developmental

Immunology. March 2005; 12(1): 1–9

Posadas I, Bucci M, Roviezzo F, Rossi A, Parente L, Sautebin L et al.

Carrageenan-induced mouse paw oedema is biphasic, age-weight

dependent and dis- plays differential nitric oxide cyclooxygenase-2 ex-

pression. Brit J Pharmacol 2004;142:331–8.

Price, S.A. & Wilson, L.M., 2006. Pathophysiology: Clinical concept of disease

processes. 6th Edition. Alih bahasa : Anugerah, P. Jakarta: EGC

Rukmana, Rahmat Ir. 1998. Stroberi Budidaya dan Pascapanen. Penerbit Kanisius

Yogyakarta.

Robbins, Stanley L, Kumar, Vnay, and Cotran, Ramzi. Robbins and Cotran

Pathologic Basis Of Disease. 8edth ed. Philadelphia: Elsavier Saunders,

2007: 27

Rowe, Raymond C., Paul J Sheskey, & Marian E Quinn (Ed). 2009. Handbook of

Pharmaceutical Excipients Sixth Edition. London: Pharmaceutical Press,

122-125

Samanta Amalesh, Gouranga Das, Sanjoy Kumar Das, 2011, Int J Pharm Sci

Tech, Roles of Flavonoid in Plants, Vol. 6

Schellack, Natalie. 2012. An Overview of Gastropathy induced by nonstreroidal

anti-inflammatory drugs. Department of Pharmacy, Faculty of Health

Science, University of Limpopo. S Afr pHARM j 2012;79(4):12-18

Seeram NP, Momin RA, Nair MG, Bourquin LD. 2001. Cyclooxygenase

xix

inhibitory and antioxidant cyanidin glycosides in cherries and berries.

(Abstract). Phytomedicine. 2001Sep;8(5):362-9 17

Seeram, N.P., Adams, L.S., Zhang, Y., Lee,R., Sand, D.,S cheuller,H.S., etal..2006.

Blackberry, black raspberry, blueberry, cranberry, red raspberry and strawberry extracs

inhibit growth and stimulate apoptosis of human cancer cells in vitro. Journal of

Agricultural and Food Chemistry

Soeroso S, Isbagio H, Kalim H, Broto R, Pramudiyo R. Osteoartritis. In: Sudoyo AW,

Setiyohadi B, Alwi I, Simadibrata M, Setiati S, (ed). Buku Ajar Ilmu Penyakit Dalam

Jilid II Edisi IV. Jakarta. Fakultas Kedokteran Universitas Indonesia. 2006. Hlm 1195-

1201.

Stankov Srdan V, 2012, The Open Inflammation Journal, Definition of

Inflammation, Cause of Inflammation and Possible Anti-inflammatory

Strategies, Vol. 5 Hal. 1-9

Sultani et al. 2012. Anti-Inflammatory Cytokines: Important Immunoregulatory

Factors Contributing to Chemotherapy-Induced Gastrointestinal

Mucositis. Chemotherapy Research and Practice Volume 2012 (2012),

Article ID 490804, 11 pages.

Supranto, J. 2007. Teknik Sampling untuk Survei dan Eksperimen. Rineka Cipta.

Jakarta. hal: 217.

Tanu, I., Syarif, A., Estuningtyas, A., Setiawati, A., Muchtar, H.A. dan Arif, A.,

2002, Farmakologi dan Terapi, Jakarta, FKUI, 216-7.

Tjay, T. H., dan Rahardja, K. (2007). Obat-Obat Penting Khasiat, Penggunaan,

dan Efek-Efek Sampingnya. Edisi ke VI. Jakarta: PT Elex Media

Komputindo: hal. 193

USDA National Nutrient Database for Standard Reference Release. Full Report

(All Nutrients) Strawberry. 2014.

Vogel, H.G., W. H, Vogel. 2002. Drug Discovery and Evaluation,

Pharmacological Assay. Heidelberg : Springer Verlag Berlin

Zheng W., Wang S.Y. Oxygen radical absorbing capacity of phenolics in

blueberries, cranberries, chokeberries, and lingonberries. 2005. J. Agric.

Food Chem; 51: 502-509.