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Peran Hepatoprotektor schisandra chinensis pada gangguan fungsi hati imbas obat antituberkulosis di RS Persahabatan Jakarta = The role of hepatoprotectors Schisandra chinensis on antituberculosis drug-related liver dysfunction at Persahabatan Hospital, Jakarta

Latar belakang: Terapi tuberkulosis menggunakan paduan obat antituberkulosis (OAT) selama 6 bulan atau lebih, berpotensi menimbulkan gangguan fungsi hati. Untuk mengatasi gangguan fungsi hati imbas OAT, sering digunakan obat-obat hepatoprotektor, walaupun efektifitasnya belum meyakinkan. Salah satu hepatoprotektor yang banyak digunakan oleh dokter-dokter di Indonesia adalah Schisandra chinensis (Hp PRO). Tujuan: Untuk melihat peran hepatoprotektor Schisandra chinensis pada gangguan fungsi hati imbas OAT. Metode: Studi experimental, dengan randomisasi dan pembanding dilakukan pada 96 penderita gangguan fungsi hati imbas OAT di RS Persahabatan Jakarta pada bulan Juni 2011 hingga September 2011. Membandingkan efek Schisandra chinensis kapsul (3 x 1 sehari) dibandingkan dengan plasebo kapsul (3 x 1 kapsul sehari) selama 2 minggu. Kadar SGOT, SGPT dan bilirubin diukur pada hari ke-1, ke-7 dan ke-14. Data dianalisa dengan mengunakan t test Hasil: Kelompok perlakuan dan kontrol masing-masing 48 penderita, kemudian dilakukan uji kesetaraan menunjukkan tidak ada perbedaan karakteristik untuk umur, jenis kelamin dan indeks massa tubuh diantara kedua kelompok. Pada hari ke-1 SGOT (perlakuan 191,2±116 U/L; kontrol 200,6±103,5 U/L; p=0,64) dan SGPT (perlakuan 156,2±96 U/L; kontrol 173,9±104,5 U/L; p=0,34), hari ke-7 SGOT (perlakuan 116,7±65,3 U/L; kontrol 128,1±81 U/L; p=0,48) dan SGPT (perlakuan 100,5±60,7 U/L; kontrol 111,6±67,1 U/L; p= 0,38), hari ke-14 SGOT (perlakuan 65,4±35,9 U/L; kontrol 72±54 U/L; p=0,58) dan SGPT (perlakuan 54,8±32,2 U/L; kontrol 56,7±31,2 U/L; p=0,86), sedangkan pada hari ke-1, ke-7 dan ke-14 penurunan bilirubin total (p=0,62), bilirubin indirek (p=0,65) dan bilirubin direk (p=0,67). Kesimpulan: Tidak terdapat perbedaan bermakna antara kelompok perlakuan dan kontrol terhadap penurunan kadar SGOT, SGPT, bilirubin total, bilirubin indirek dan bilirubin direk.
Kata kunci: Antituberkulosis, Schisandra chinensis, disfungsi hati, hepatitis imbas obat.


Background: Tuberculosis treatment using combined antituberculosis drugs over 6 months or more is potential to cause liver dysfunction. Hepatoprotective drugs are frequently used for antituberculosis drug-related hepatotoxicity although they have not been confirmed effective. One of hepatoprotectors that is widely used by Indonesia physician is Schisandra chinensis (Hp PRO). Objective: To observe the role of hepatoprotectors Schisandra chinensis on antituberculosis drug-related liver dysfunction Methods: A randomized-controlled experimental study was conducted on 96 patients with antituberculosis-related liver dysfunction at Persahabatan Hospital, Jakarta between June 2011 and September 2011. The effects of Schisandra chinensis capsule, three times daily, was compared with placebo capsule, three capsules daily, for 2 weeks. ALT, AST and bilirubin levels were measured on the day 1, 7 and 14. Data were analyzed by using t-test. Result: There were 48 patients in each treatment. Normality test demonstrated no differences of subject characteristics regarding the age, sex and body mass index in both groups. On day 1, AST levels in treatment group was 191.2±116 IU/L and in control group was 200.6±103,5 IU/L (p=0.64); while ALT levels in treatment group was 156.2±96 IU/L and in the control group was 173.9±104,5 IU/L (p=0.34). On day 7, AST levels in treatment group was 116.7±65,3 IU/L and in the control group was 128.1±81 IU/L (p=0.48); while ALT levels in the treatment group was 100.5±60,7 IU/L and in the control group was 111.6±67,1 IU/L (p=0.38). On day 14, AST levels in treatment group was 65.4±35,9 IU/L and in the control group was 72±54 IU/L (p= 0.58); while ALT levels in treatment group was 54.8±32,2 IU/L and in the control group was 56.7±31,2 IU/L (p=0.86). Furthermore, on day 1, 7 and 14, there were decreased total bilirubin level (p=0.62), indirect bilirubin level (p=0.65) and direct bilirubin level (p=0.67). Conclusions: There are no significant differences on decreased AST, ALT, total bilirubin, direct and indirect bilirubin levels between the treatment and control group
Keywords: Antituberculosis, Schisandra chinensis, liver dysfunction, drug-induced hepatitis