i

Perbedaan Efektifitas Ekstrak Daun Seledri Dan Buah Alpukat

Terhadap Perubahan Kadar Kolesterol Total Pada Tikus Putih

Jantan (Rattus norvegicus strain wistar) Dengan Hiperkolesterolemia

SKRIPSI

Oleh :

ENGKI BIUL TAMBOSIS

NIM. 201310420311075

PROGRAM STUDI ILMU KEPERAWATAN

FAKULTAS ILMU KESEHATAN

UNIVERSITAS MUHHAMMADIYAH MALANG

2019

ii

iii

iv

KATA PENGANTAR

Puji dan Syukur Alhamdulillah saya panjatkan kehadirat Allah SWT, berkat rahmat

dan bimbingan-Nya saya dapat menyelesaikan skripsi dengan judul “Perbedaan

Efektifitas Ekstrak Daun Seledri dan Ekstrak Buah Alpukat Terhadap Perubahan

Kadar Kolesterol Total pada Tikus Putih Jantan (Rattus Norvegicus Strain Wistar)

dengan Hiperkolesterolemia”. Skripsi ini dibuat sebagai salah satu syarat guna

memperoleh gelar sarjana keperawatan (S.Kep) pada Program Studi Ilmu Keperawatan

Fakultas Ilmu Kesehatan Universitas Muhammadiyah Malang.

Bersamaan dengan ini perkenankanlah saya mengucapkan terima kasih yang

sebesar-besarnya dengan hati yang tulus kepada:

1. Bapak Faqih Ruhyanuddin., M.Kep., SP.Kep. MB. selaku Dosen Penguji I Dan

Dekan Fakultas Ilmu Kesehatan Universitas Muhammadiyah Malang.

2. Ibu Nur Lailatul M., S. Kep., Ns., MNS. selaku Ketua Program Studi Ilmu

Keperawatan Fakultas Ilmu Kesehatan Universitas Muhammadiyah Malang.

3. Bapak Edi Purwanto, S.Kep, Ns, MNg. selaku Dosen Pembimbing 1 yang sabar

dan dengan kebesaran hati dalam membimbing saya untuk mewujudkan skripsi ini.

4. Ibu Anggraini Dwi Kurnia, MNS selaku Dosen Pembimbing 2 saya yang dengan

sabar telah membimbing saya, mengarahkan dan memberi masukan yang sangat

membangun.

5. Ibu Risa Herlianita, MSN. Selaku dosen penguji 2 yang telah memberikan masukan

dan saran-saran untuk melengkapi tugas akhir ini.

v

6. Ibu Indri Wahyuningsih, Ns, S.Kep. selaku Dosen Wali PSIK B angkatan 2013

yang selalu memberikan dukungan untuk menyelesaikan skripsi ini.

7. Seluruh Dosen dan staf TU, Program Studi Ilmu Keperawatan Fakultas Ilmu

Kesehatan Universitas Muhammadiyah Malang yang tidak dapat penulis sebutkan

satu persatu atas ilmu dan bantuan yang telah diberikan kepada penulis.

8. Ayahanda (H. Ratim) dan Ibunda (Kartip Hidayatul Yani) serta keluarga yang tiada

henti-hentinya selalu mendoakan, memberikan dukungan moril, materiil, spiritual,

motivasi dan kasih sayang bagi peneliti selama menempuh pendidikan di

Universitas Muhammadiyah Malang.

9. Teman-teman PSIK B 2013 dan semua pihak yang namanya tidak bisa saya

sebutkan satu persatu yang turut membantu menyelesaikan skripsi ini.

Penulis menyadari bahwa penyusunan skripsi ini masih jauh dari kata sempurna,

oleh karena itu saya membuka diri untuk segala kritik dan sarannya. Semoga skripsi ini bisa

disetujui dan segera direalisasikan sehingga bermanfaat bagi masyarakat dan dunia

kesehatan khususnya di bidang keperawatan.

Wassalamualaikum. Wr.Wb.

Malang, 27 September 2019

Penuli

viii

DAFTAR ISI

Halaman Juduli ......................................................................................................................... i

Lembar Pengesahan ................................................................................................................. ii

Surat Pernyataan Keasliaan Penelitian ................................................................................... iii

Kata Pengantar ......................................................................................................................... iv

Abstrak ....................................................................................................................................... vi

Daftar Isi .............................................................................................................................. viii

Daftar Tabel ........................................................................................................................ xii

Daftar Gambar ................................................................................................................... xiii

Daftar Singkatan ................................................................................................................. xiv

Daftar Lampiran ................................................................................................................. xv

BAB 1 PENDAHULUAN

1.1 Latar Belakang ..................................................................................................... 1 1.2 Rumusan Masalah .............................................................................................. 6 1.3 Tujuan Penelitian ............................................................................................... 6

1.3.1 Tujuan Umum ........................................................................................... 6 1.3.2 Tujuan Khusus ......................................................................................... 6

1.4 Manfaat Penelitian ............................................................................................. 7 1.4.1 Manfaat Teoritis ....................................................................................... 7

1. Bagi Perkembangan Ilmu Pengetahuan ................................................... 7 1.4.2 Manfaat Praktis ......................................................................................... 7

1. Bagi Peneliti ................................................................................................. 7 2. Bagi Profesi Keperawatan .......................................................................... 7 3. Bagi Masyarakat ........................................................................................... 7 4. Bagi Institusi Pendidikan Kesehatan ....................................................... 8 5. Bagi Layanan Kesehatan ............................................................................ 8

1.5 Batasan Penelitian .............................................................................................. 8 1.6 Keaslian Penelitian ............................................................................................ 8

BAB II TINJAUAN PUSTAKA

2.1 Lipid ...................................................................................................................... 13 2.2 Kolesterol ............................................................................................................. 13

2.2.1 Definisi ....................................................................................................... 13 2.3 Metabolisme Lipoprotein .................................................................................. 14

2.3.1 Jenis Lipoprotein ...................................................................................... 14 2.3.2 Jalur Metabolisme Eksogen ................................................................... 16 2.3.3 Jalur Metabolisme Endogen .................................................................. 16

ix

2.3.4 Jalur Reserve Cholesterol Transport .................................................... 17 2.3.5 Hiperkolesterolemia ................................................................................. 17 2.3.6 Hiperkolesterolemia Primer .................................................................... 18 2.3.7 Hiperkolesterolemia sekunder ............................................................... 18

2.4 Klasifikasi Kolesterol ........................................................................................ 18 2.4.1 Total kolesterol ........................................................................................ 18 2.4.2 HDL Kolesterol (Hight Density Lipoprotein) ..................................... 19 2.4.3 LDL Kolesterol (Low Density Lipoprotein) ........................................ 19 2.4.4 Trigliserida ................................................................................................ 19

2.5 Faktor Resiko ...................................................................................................... 19 2.6 Penatalaksanaan Medis....................................................................................... 20 2.7 Seledri (Apium Graveolens L.) .............................................................................. 22

2.8.1 Klasifikasi Seledri (Apium Graveolens L.) ................................................. 22 2.8.2 Morfologi Tanaman Seledri (Apium Graveolens L.) ................................ 23 2.8.3 Kandungan Ekstrak Daun Seledri (Apium Graveolens L.) ..................... 24 2.8.4 Konsep Efektifitas Daun Seledri Terhadap Perubahan Kadar Kolesterol Total Pada Tikus Putih Jantan Dengan Hiperkolesterolemia ................................................................................. 27

2.9 Alpukat (Persea Americana Mill) ......................................................................... 28 2.9.1 Klasifikasi Alpukat (Persea Americana Mill) ............................................. 28 2.9.2 Morfologi Tanaman Alpukat (Persea Americana Mill) ............................ 29 2.9.3 Kandungan Ekstrak Daun Alpukat (Persea Americana Mill) ................. 30 2.9.4 Konsep Efektifitas Buah Alpukat Terhadap Perubahan Kadar Kolesterol Total Pada Tikus Putih Jantan Dengan Hiperkolesterolemia ................................................................................. 32

2.10 Efek Samping Dari Ekstrak Daun Seledri (Apium Graveolens L.) Dan Daun Alpukat (Persea Americana Mill) .................................................... 33

2.11 Tikus33 2.11.1 Klasifikasi Tikus Putih (Rattus Norvegicus Strain Wistar) .................... 33 2.11.2 Morfologi Tikus Putih (Rattus Norvegicus Strain Wistar) .................... 34

BAB III KERANGKA KONSEP DAN HIPOTESIS PENELITIAN

3.1 Kerangka Konsep .............................................................................................. 36 3.2 Hipotesis Penelitian ........................................................................................... 39

BAB IV METODE PENELITIAN

4.1 Desain Penelitian ............................................................................................... 40 4.2 Skema Penelitian ................................................................................................. 41 4.3 Populasi, Sampel, Dan Sampling ..................................................................... 42

4.3.1 Populasi ..................................................................................................... 42 4.3.2 Sampel ........................................................................................................ 42 4.3.3 Besar Sampel ............................................................................................. 43 4.3.4 Sampling ..................................................................................................... 44

4.4 Variabel Penelitian ............................................................................................. 45

x

4.4.1 Variabel Independen ................................................................................. 45 4.4.2 Variabel Dependen ................................................................................... 46 4.4.3 Variabel Kontrol........................................................................................ 46

4.5 Definisi Operasional ......................................................................................... 47 4.6 Tempat Penelitian .............................................................................................. 49 4.7 Waktu Penelitian ................................................................................................. 49 4.8 Bahan Dan Instrumen Penelitian .................................................................... 49

4.8.1 Pemeliharaan Tikus ................................................................................... 49 4.8.2 Pembuatan Tikus Hiperkolesterolemia .................................................. 50 4.8.3 Ekstraksi Daun Seledri (Apium Graveolens L.) ........................................ 50 4.8.4 Ekstraksi Buah Alpukat (Persea Americana Mill)..................................... 51 4.8.5 Observasi Perubahan kadar kolesterol total .......................................... 51

4.9 Prosedur Penelitian ............................................................................................. 52 4.9.1 Pembagian Kelompok Tikus ................................................................... 52 4.9.2 Proses Adaptasi ......................................................................................... 53 4.9.3 Pembuatan Ekstrak Daun Seledri (Apium Graveolens L.) .................... 53 4.9.4 Pembuatan Ekstrak Buah Alpukat (Persea Americana Mill) .................. 55 4.9.5 Proses Perawatan Dan Pengamatan Perubahan Tekanan Darah

Pada Tikus ................................................................................................. 57 4.9.6 Alur Kerja ................................................................................................... 57

4.10 Analisis Data ...................................................................................................... 58 4.11 Etika Penelitian.................................................................................................. 58

BAB V HASIL PENELITIAN DAN ANALISA DATA

5.1 Karakteristik Sampel .......................................................................................... 60 5.2 Proses Penelitian ................................................................................................. 62 5.3 Hasil Penelitian .................................................................................................... 63

5.3.1 Identifikasi Perubahan Kadar Kolesterol Total Pada Tikus Putih Jantan Setelah Pemberian Fruktosa 10%, Ekstrak seledri Dan Ekstrak Buah ......................................................... 63

5.4 Analisa Data ......................................................................................................... 64

BAB VI PEMBAHASAN

6.1 Interpretasi Dan Diskusi Hasil .......................................................................... 66 6.1.1 Kadar Kolesterol Total Tikus Putih Jantan Setelah Diberikan

Fruktosa 10% ............................................................................................ 66 6.1.2 Kadar Kolesterol Total Tikus Putih Jantan Setelah Diberikan Fruktosa 10%, Dan Ekstrak Daun Seledri ............................................ 67 6.1.3 Kadar Kolesterol Total Tikus Putih Jantan Setelah Diberikan

Fruktosa 10%, Dan Ekstrak Buah Alpukat .......................................... 69 6.1.4 Perbedaan Ekstrak Daun Seledri Dan Buah Alpukat .......................... 70

6.2 Keterbatasan Penelitian ...................................................................................... 71 6.3 Implikasi Untuk Bidang Keperawatan ............................................................. 72

xi

BAB VII KESIMPULAN DAN SARAN

7.1 Kesimpulan .......................................................................................................... 74 7.2 Saran ...................................................................................................................... 75

7.2.1 Bagi Penulis Dan Peneliti Lain ................................................................ 75 7.2.2 Bagi Masyarakat ......................................................................................... 75 7.2.3 Bagi Profesi Keperawatan Dan Layanan Kesehatan Lain ................... 75

DAFTAR PUSTAKA ................................................................................................... 77

LAMPIRAN ................................................................................................................... 81

xii

DAFTAR TABEL

Tabel 2.1 Kategori Kolesterol Total .................................................................................. 18

Tabel 2.2 Kategori HDL ...................................................................................................... 19

Tabel 2.3 Kategori LDL Kolesterol.................................................................................... 19

Tabel 2.4 Kategori LDL Kolesterol.................................................................................... 19

Tabel 4.1 Definisi Operasional ............................................................................................ 46

Tabel 5.1 Rata-Rata Hasil Penelitian .................................................................................. 64

Tabel 5.2 Hasil Uji Normalitas Dengan Metode Shapiro-Wilk .................................... 65

xiii

DAFTAR GAMBAR

Gambar 2.1 Seledri (Apium Graveolens L.) .......................................................................... 23

Gambar 2.2 Alpukat (Persea Americana Mill) ...................................................................... 29

Gambar 2.3 Rattus norvegicus strain wistar ............................................................................. 34

Gambar 3.1 Kerangka Konsep “erbedaan Evektifitas Daun Seledri dan Buah Alpukat

Terhadap Perubahan Kadar Kolesterol Total Pada Tikus Putih Jantan (Ratus Norvegicus

Wistart Penderita Hierkolesterolemia .......................................................................................... 36

Gambar 4.1 Rancangan Penelitian: Pre-Post Test Kontrol Group Design ............................. 40

Gambar 4.2 Skema penelitian: Perbedaan efektifitas ekstrak daun seledri (Apium Graveolens

L.) dan ekstrak buah alpukat (Persea Americana Mill) terhadap perubahan kadar kolesterol

total pada tikus putih jantan (Rattus Norvegicus Strain Wistar) dehiperkolesterolemia .... 41

Gambar 4.3 Teknik Sampling (random sampling) ............................................................ 45

Gambar 5.1 Proses Intervensi (7 minggu) ......................................................................... 60

Gambar 5.2 Proses Penelitian.............................................................................................. 62

xiv

DAFTAR SINGKATAN

HDL : High Density Lipoprotein

LDL : Low Density Lipoprotein

PJK : Penyakit Jantung Koroner

CHD : Coronary Heart Disease

WHO : World Health Organization

BBT : Biological base Therapies

VLDL : Very Low Density Lipoprotein

SBP : Sistolic Blood Pressure

HR : Heart Rate

TG : Triglycerides

TC : Total Cholesterol

AI : Atherogenic Indeks

PT : Protombine Time

PTTK : Partial Tromboplastin Time with Kaolin

MUFA : Monoansaturated fatty acid

IDL : Intermediate Density Lipoprotein

PUFA : Polyunsaturated Fatty Acid

DNA : Deoxyribonucleic Acid

Mg : Mili Gram

SPSS : Statistical Product and Service Solution

Kg :Kilo gram

xv

DAFTAR LAMPIRAN

Lampiran 1 SOP (Cara Membuat Ekstrak Daun Seledri) ............................................... .. 81

Lampiran 2 SOP (Cara Menginduksi Tikus Menggunakan Fruktosa 10%).................. .. 83

Lampiran 3 SOP (Cara Mengukur Kadar Kolesterol Total Pada Tikus) ...................... .. 84

Lampiran 4 SOP (Cara Membuat Ekstrak Buah Alpukat) .............................................. .. 86

Lampiran 5 Lembar Observasi Kadar Kolesterol Total

(Intervensi Ekstrak Daun Seledri) ................................................................ .. 88

Lampiran 6 Lembar Observasi Kadar Kolesterol Total

(Intervensi Ekstrak Buah Alpukat) ............................................................... .. 89

Lampiran 7 Lembar Observasi Kadar Kolesterol Total (Induksi Fruktosa 10%) ....... .. 90

Lampiran 8 Hasil Penelitian ................................................................................................. .. 91

Lampiran 9 Tabulasi data ..................................................................................................... .. 94

Lampiran 10 Hasil Analisa data ........................................................................................... .. 96

Lampiran 11 Dokumentasi Penelitian ................................................................................ .. 99

Lampiran 12 Surat Studi Pendahuluan .............................................................................. 107

Lampiran 13 Surat Pengajuan Etik .................................................................................... 109

Lampiran 14 Surat Ekstraksi Seledri ................................................................................. 110

Lampiran 15 Surat Ekstraksi Alpukat ............................................................................... 111

Lampiran 16 Surat Kode Etik ............................................................................................. 112

Lampiran 17 Surat Telah Melakukan Penelitian .............................................................. 113

Lampiran 18 Lembar Konsultasi ....................................................................................... 114

Lampiran 19 Lembar Plagiasi .............................................................................................. 119

77

DAFTAR PUSTAKA

Anies. 2015. Kolesterol & Penyakit Jantung Koroner: Solusi Pencegahan Dari Aspek Kesehatan Masyarakat. Jogjakarta. Ar-Ruzz Media.

Agoes, Azwar. (2010). Tanaman Obat Indonesia. Jakarta: Salemba Medika, 60-61. Alexandru, I. (2011). Experimental Use of Animals in Research Spa. Journal of Balneo

research, 2(1), 65-69. Campos VC dan L Tappy. (2016). Physiological handling of dietary fructose-containing

sugars: implications for healt. International Journal of Obesity, 40, S6–S11. Chaiirinniza K,. Graha. 2010. 100 Question & answers: Kolesterol. Jakaarta. PT Elex Media

Komuputindo.

Castillo, F., D. Hernandez, G. Gallegos, R. guez and C. N. Aguilar (2012). Antifungal Properties of Bioactive Compounds from Plants, Fungicides for Plant and Animal Diseases, Dr. Dharumadurai Dhanasekaran (Ed.). InTech: 81-108.

Dalimarta. (2011).Pengaruh ekstrak alpukat (Persea americana) terhadap penurunan kadar

kolesterol total pada tukus putih jantan (Rattus Novergicus Strain Wistar) hyperlipidemia. Fakultas Kedokteran Universitas Muhammadiyah Malang. (6-8).

Department of Agriculture, Forestry and fisheries. (2013). Celery (Apiumgraveolens

L.).Afrika: Plant Production, 1-3. Dianat, M., Veisi, A., Ahangarpour, A., & Moghaddam, H.F. (2015). The effect of hydro-

alcoholic celery (Apiumgraveolens) leaf extract on cardiovascular parameters and lipid profile in animal model of hypertension induced by fructose. Avicenna Journal of Phytomedicine.

Elsayed Elbadrawy & Lobna Shelbaya. (2013). Hypolipidemic activities of hydroalcoholic

extract of avocado fruit on high cholesterol fed diet in rats and its antioxidant effect in vitro. Journal of American Science.

Eggermont, J.J. (2012). The Neuroscience of Tinnitus. Inggris: Oxford University Press, 74-75. Esmail, A., & Snafi, A. (2014). The Pharmacology of Apium graveolens.-A Review. Journal of

International Journal for Pharmaceutical. Fitria, Triola & Saputra, Oktadoni. (2014). Khasiat Daun Seledri ( Apium graveolens )

Terhadap Tekanan Darah Tinggi Pada Pasien Hiperkolestrolemia. (Skripsi). Lampung: Universitas Kedokteran Lampung, 3-4.

78

Gouegni, E.F., & Abubakar.H., (2013).Phytochemical, Toxicological, Biochemical and Haematological Studies on Avocado (Persea americana) in Experimental Animals. Nigerian Food Journal.

Habibah, Indah Kholisatul. (2013). Pengaruh Ekstrak Alpukat (Persea Americana)

Terhadap Penurunan Kadar Low Density Lipoprotein (LDL) Pada Tikus Putih Jantan (Rattus Novergicus Strain Wistar) Hiperkolesterolemia. Journal of Univercity Muhhamadiyah Malang.

Hardani, A., Afzalzadeh, M.R., Amirzargar, Ashraf., Mansouri, Esrafil., & Meamar,

Zakieh. (2015). Effects of aqueous extract of celery (Apium graveolens L.) leaves on spermatogenesis in healthy male rats. Avicenna Journal of Phytomedicine.

Hani, Ratu & Edward, J. (2016). 350 Jus Kesehatan dan Kebugaran.Jakarta: Demedia, 23-24. Hidayat, R.S., & napitupulu, R.M. (2015). Kitab Tumbuhan Obat. Jakarta: Agriflo, 42-43. Hidayat. (2007). Metode penelitian Kebidanan dan Teknik Analisis Data. Jakarta: Salemba

Medika. Hal 79. Huberech, Robert & Kirkwood, James. (2010). The Care and Management of Laboratory and

Other Research Animal. University Federation for Animal Welfare, 312-313. Jorge, V.G., Ángel , J.R.L., Adrian, T.S., Francisco, A.C., Anur, S.G., Samuel, E.S., Angel,

S.O., & Emmanuel, H.N. (2013). Vasorelaxant Activity of Extracts Obtained From Apium Graveolens: Possible Source for Vasorelaxant Molecules Isolation With Potential Antihypertensive Effect. Journal of Tropical Biomedicine.

Kemenkes. (2018). Profil Kesehatan Indonesia Tahun 2017. Jakarta : Kementerian

Kesehatan Republik Indonesia. Kolderup Astrid dan Birger Svihus. (2015). Review Article Fructose Metabolism and

Relation to Atherosclerosis, Type 2 Diabetes, and Obesity. Journal of Nutrition and Metabolism.

Kooti Wesam, Ghasemiboroon Maryam, Asadi-Samani Majid, Ahangarpoor Akaram,

Noori Ahmad Abadi Mosayeb, Afrisham Reza, Dashti Nader. (2014). The Effects of Hydro-Alcoholic Extract of Celery on Lipid Profile of Rats Fed a High Fat Diet. Advances in Environmental Biology. 8 (9), 325 & 327.

Kooti, W., Akbari, S.A., Samani, M.A., Ghadery, H., & Larky, D.A. (2014). A Review on

Medicinal Plant of Apium Graveolens.Journal of Herbal Medicine. Kurniawan, Reiza Farandika. (2014). Khasiat Dahsyat Alpukat Mengobati dan Mengatasi Semua

Penyakit. Perpustakaan Nasional: Healty Books, 65-66.

79

Lianti Revina. (2014). Khasiat Dahsyat Buah Alpukat Mengobati & Mencegah Semua Penyakit. Jakarta. Healthy Books. 56.

Maghfiroh Hikmatul. (2013). Pengaruh Ekstrak Alpukat (Persea americana) Terhadap

Penurunan Kadar Kolesterol Total Pada Tikus Putih Jantan (Rattus Novergicus Strain Wistar) Hiperlipidemia. Skripsi Universitas Muhammadiyah Malang.

Manal M,. S,. M,. Shehata. & Sahar S,. A,. Soltan. (2012). The Effects of Purslane and

Celery on Hypercholesterolemic Mice. World Journal of Dairy & Food Sciences.

Manal M.S.M. Shehata and Sahar S.A. Soltan. (2013). Effects of Bioactive Component of Kiwi Fruit and Avocado (Fruit and Seed) on Hypercholesterolemic Rats. World Journal of Dairy & Food Sciences. 8 (1): 83, 84, 87.

Manoj Kumar, Ravinder Nagpal, RajeshKumar, R,. Hemalatha, Vinod Verma, Ashok Kumar, Chaitali Chakraborty, Birbal Singh, Francesco Marotta, Shalini Jain, & Hariom Yadav. (2012). Review Article: Cholesterol-Lowering Probiotics as Potential Biotherapeutics for Metabolic Diseases. Experimental Diabetes Research

M, Manal.S., Shehataa & Soltan, Sahar.S.A. (2012). The Effects of Purslane and Celery on Hypercholesterolemic Mice. World Journal of Dairy & Food Sciences.

Marston, W. (2013). Saponins in Food, Feedstruffs and Medical Plants. Jerman: Springer, 15-16. Nevers, G., Edelman, D.S., Merenlender, A.M. (2013). The California Naturalist Handbook.

London: University of California Press, 33-34. Nursalam. (2008). Konsep dan Penerapan Metodelogi Penelitian Ilmu Keperawatan (Pedoman Skripsi,

Tesis, dan Instrument Penelitian Keperawatan Edisi 2). Jakarta: Salemba medika, 91-93. Oyeyemi, A.R. (2015). Effect of the Aqueous Extract of the Leaves and Seeds of Avocado

Pear (Persea Americana) On Some Marker Enzymes and Cholesterol in the Albino Rat Tissues. Journal of Environmental Science, Toxicology and Food Technology.

Paramawati, R., & Dumilah, D.R. (2016). Khasiat ajaib Daun Avocad. Jakarta: Penebar

Swadaya, 8-49. Pavan Chaudhary, Jainik Khamar and Prof. Dr. Dhrubo Jyoti Sen (2015). Avocado: The

Holistic Source As A Natural Ddoctor. World Journal of Pharmaceutical Research. Volume 4, Issue 8, 758-759.

Putra, W.S. (2013). 68 Buah Ajaib Penangkal Penyakit. Yogyakarta: Katahari, 2-49. Raju, M.P., Babu, D.G.A., Kumar, B.R., & Rajashekar, C.H. (2013). The Role of

Phytosterols Enriched Foods-A Review. Journal Of Environmental Science, Toxicology And Food Technology (IOSR-JESTFT).

80

Riskesdas. (2013). Laporan Riset Kesehatan Dasar Tahun 2013. Jakarta: Badan Penelitian Triyanto, Endang. (2014). Pelayanan Keperawatan bagi Penderita Hipertensi Secara Terpadu.

Yogyakarta: Graha Ilmu, 47.

Raymond, J. (2011). The Path to A Vibrant Health: A Multi-Dimentional Approach to Health. USA: Authorhouse. 23-24.

Rahardjo, R. (2008). Kumpulan Kuliah Farmakologi. Jakarta: EGC. Sugiyono. (2011). Metode Penelitian Kuantitatif dan Kualitatif. Bandung: ALFABETA, 215-

230.

Sani K., F. (2016). Metodelogi Penelitian Farmasi Komunitas dan Eksperimental. Yogyakarta: Deepublish (Grup Cv Budi utama). 52-53.

Sharma, S., Dwivedi, J., Agrawal, M., & and Paliwal, S. (2012). Cytoprotection Mediated

Antiulcer Effect Of Aqueous Fruit Pulp Extract Of Cucumis Sativus. Asian Pacific Journal of Tropical Disease, 61-67.

Stanley, J.C., Veith, F.J., & Wakefield, T.W. (2014). Curren Therapy in Vascular and

Endovascular Surgery. USA: Elsivier. Sunarjono Hendro. (2013). Bertanam 36 Jenis Sayur. Jakarta. Penebar Swadaya. 100. Triyanto, Endang. (2014). Pelayanan Keperawatan bagi Penderita Hipertensi Secara Terpadu.

Yogyakarta: Graha Ilmu, 7-47. Umarudin, Susanti, R., & Yuniastuti, A. (2012). Efektifitas Ekstrak Tanin Seledri Terhadap

Profil Lipid Tikus Putih Hiperkolosterolemi. (Skripsi). Semarang: Universitas Negeri Semarang.

Vinha, A.F., Moreira, Joena., & Barreira, S.V.P. (2013). Physicochemical Parameters,

Phytochemical Composition and Antioxidant Activity of the Algarvian Avocado (Persea Americana Mill.). Journal of Agricultural Science.

Wong Alfred. (2013). Chemical and microbiological considerations of phytosterols and

their relative efficacies in functional foods for the lowering of serum cholesterol levels in humans: A review. Journal Of Functional Foods. Vancouver V6J 4N1.

119

Lampiran 19 Lembar Plagiasi

Lembar Plagiasi

120