GAMBARAN PENGGUNAAN PENGOBATAN TRADISIONAL DAN KOMPLEMENTER PADA PASIEN PENYAKIT PARU OBSTRUKTIF KRONIK (PPOK): SEBUAH LITERATURE REVIEW

INDAH FAJAR DESTANTIKA, Dwi Harjanto, S.Kp., M.Sc; Intansari Nurjannah, S.Kp., MN.Sc., Ph.D

2021 | Skripsi | S1 ILMU KEPERAWATAN

Latar belakang: Penyakit Paru Obstruktif Kronik (PPOK) merupakan penyakit yang ditandai dengan gejala sesak, batuk kronis dan produksi dahak. Penderita PPOK sangat kesulitan dalam melakukan aktivitas sehari-hari karena kondisi yang semakin memburuk. Penelitian telah menunjukkan bahwa penderita PPOK beralih ke pendekatan pengobatan alternatif dan komplementer dengan tujuan untuk mengurangi gejala. Belum adanya penelusuran berdasarkan evidence terkait pengobatan tradisional dan komplementer pada pasien PPOK membuat peneliti tertarik untuk melakukan literature review mengenai gambaran penggunaan pengobatan tradisional dan komplementer pada pasien PPOK. Tujuan penelitian: Mengidentifikasi gambaran penggunaan pengobatan tradisional dan komplementer pada pasien PPOK sesuai dengan evidence terkini. Metode: Penelitian ini merupakan literature review (narrative review). Pencarian artikel dilakukan pada database Clinical Key, Cochrane Library, PMC, PubMed, ScienceDirect dan Google Scholar dengan memasukkan kata kunci P: Chronic Obstructive Pulmonary Disease, I: Traditional and Complementary Medicine, C: -, O: -. Skrining artikel dilakukan dengan tahapan yang diadaptasi diagram alur PRISMA. Analisis data dilakukan dengan memasukkan artikel yang sudah terpilih ke dalam matriks dengan kategori: peneliti (tahun), judul level of evidence, tujuan penelitian, metode penelitian, hasil penelitian dan kesimpulan penelitian. Pada identifikasi awal didapatkan 232 artikel dan 12 artikel diantaranya terpilih untuk dianalisis. Hasil: Sebelas dari dua belas artikel termasuk ke level of evidence 1b dan satu artikel termasuk ke level of evidence 2b. Seluruh artikel termasuk ke tingkat rekomendasi B, sehingga seluruh artikel dapat direkomendasikan dan berimplikasi pada kepentingan klinis. Jenis-jenis pengobatan tradisional dan komplementer yang digunakan pada pasien PPOK kronik berdasarkan input terapeutik utama, terbagi menjadi pendekatan nutrisi dan pendekatan kombinasi (psikologis dan fisik). Pengobatan tradisional dan komplementer dapat digunakan untuk mengelola gejala pada pasien PPOK. Pengobatan tradisional dan komplementer pada pasien penyakit paru obstruktif kronik yang dapat digunakan di Indonesia, antaralain rhubarb, serat makanan ampas tebu, Integrated Approach of Yoga Therapy, akupunktur, Tai Chi Qigong dan Progressive muscle relaxation. Kesimpulan: Macam-macam pengobatan tradisional dan komplementer yang digunakan pada pasien PPOK, antaralain rhubarb, Bufei, Bushen Yiqi, Bushen Fangchuan, serat makanan ampas tebu, Ninjin’yoeito, formula Xuan Bai Cheng Qi, Integrated Approach of Yoga Therapy, akupunktur, Tai chi Qigong, Liuzijue Qigong dan Progressive Muscle Relaxation. Pengobatan tradisional dan komplementer yang digunakan pada pasien PPOK menunjukkan hasil dapat mengurangi gejala, frekuensi eksaserbasi akut, gejala depresi dan kecemasan, meningkatkan fungsi paru, kadar gas darah arteri, kualitas hidup, kapasitas latihan, saturasi oksigen, mengendalikan respon inflamasi, serta memulihkan status nutrisi.

Background: Chronic Obstructive Pulmonary Disease (COPD) is a disease characterized by shortness of breath, chronic cough and phlegm production. People with COPD have difficulty in performing daily activities because the condition is getting worse. Research had shown that people with COPD turned to alternative and complementary medicine approaches with the aim of reducing symptoms. The absence of evidence-based searches related to traditional and complementary medicine in COPD patients made researchers were interested in conducted a literature review on the description of the use of traditional and complementary medicine in COPD patients. Objective: Identified the description of the use of traditional and complementary medicine in COPD patients according to the latest evidence. Methods: This research was a literature review (narrative review). Article searches were conducted on the Clinical Key, Cochrane Library, PMC, PubMed, ScienceDirect and Google Scholar databases by entered the keywords P: Chronic Obstructive Pulmonary Disease, I: Traditional and Complementary Medicine, C: -, O: -. Article screening was carried out in stages adapted to the PRISMA flowchart. Data analysis was carried out by entering selected articles into a matrix with categories: researcher (year), title level of evidence, research objectives, research methods, research results and research conclusions. In the initial identification, 232 articles were obtained and 12 of them were selected for analyzed. Results: Eleven of the twelve articles belong to the level of evidence 1b and one article belongs to the level of evidence 2b. All articles belong to the recommendation level B, so that all articles can be recommended and have implications for clinical importance. The types of traditional and complementary medicine (T&CM) used in COPD patients are based on the main therapeutic input, divided into a nutritional approach and a combination approach (psychological and physical). T&CM can be used to manage symptoms in COPD patients. T&CM treatments for patients with chronic obstructive pulmonary disease that can be used in Indonesia include rhubarb, bagasse dietary fiber, Integrated Approach of Yoga Therapy, acupuncture, Tai Chi Qigong and Progressive muscle relaxation. Conclusion: Various kinds of traditional and complementary medicine used in COPD patients, included rhubarb, Bufei, Bushen Yiqi, Bushen Fangchuan, sugarcane bagasse dietary fiber, Ninjin'yoeito, Xuan Bai Cheng Qi formula, Integrated Approach of Yoga Therapy, acupuncture, Tai chi Qigong , Liuzijue Qigong and Progressive Muscle Relaxation. Traditional and complementary medicine used in COPD patients had showed results in reducing symptoms, frequency of acute exacerbations, symptoms of depression and anxiety, improving pulmonary function, arterial blood gas levels, quality of life, exercise capacity, oxygen saturation, controlling the inflammatory response, and restoring nutritional status.

Kata Kunci : pengobatan tradisional dan komplementer, penyakit paru obstruktif kronik