HERBAL MEDICINE

Perkembangan herbal
medicine di
indonesia
dr. HARDHI
PRANATA
P.D.H.M.I

National Commitment
27 Mei 2008: President of Indonesia
(SBY) declare Gelar Kebangkitan
Jamu to integrate Jamu in formal
health system and jamu as a national
heritage
UU no.36 2009: Traditional health
should be included in National Health
Care
Permenkes 2010: Scientification of
Jamu

Global Commitment
2009, Ranggoon (Myanmar): WHO
regional meeting on the use of herbal
medicine in primary health care
2010, Hanoi (Vietnam): 2nd
conference on traditional medicine in
asian countries Integration of
traditional medicine into the National
Healthj Care Systems:

CLINICAL GUIDE

ROLE OF HERBAL MEDICINE

(Medical Plant)
Promotive

Preventi
Curative
ve

Rehabilita
tive

Palliative

Food

Supplement

Complement

Drug

HERBAL MEDICINE (Medicinal

Plant)
54,3 % Indonesian people use it as traditional
medicine
Hippocrates (Father of Modern Medicine):
Let food be your medicine and medicine be
your food
Medicinal plant in Indonesia use as
o
o
o
o

Food (ginger, turmeric, chili, garlic, celery, etc)

Supplement (garlic, white curcuma, etc)
Complementary (guava, Phaleria macrocarpa)
Drug (Phyllantus niruri, gotukola, andrographis
paniculata,
celeri)

SWOT Analysis of Medicinal

Plant
STRENGTH
Biological more compatible to human body
Could be used as food supplement,
complement, drug
Less side effect, one herbs, multi compound,
that acts synergistically
Indonesia is the fifth mega biodiversity
About 33.000 potentially plant could be used as
medicine
Traditionally used for thousand years
Cheap
Broad indication as health promotion,
preventive, curative, rehabilitative, palliative of
diseases

 WEAKNESS
Raw material contamination with bacterial,
mold, heavy metal
Quality and quantity depend on soil,
environment, season, climate changes
Has a complex formula depends on peoples
experience
Less evidence based and Mostly empirical
based experience
In Indonesia only a few phytopharmaca

 OPPORTUNITY

Trend of Back to Nature

Economical value potential
Indonesia is a mega diversity country
Degenerative disease and metabolism disorder
tends to be increased in this millenium ages

THREAT
Global warming and climate changes
Environment contamination with pesticide,
heavy metal, and pollution
Less numbers of medicinal plants caused by
urban development

PRINCIPLE USE OF MEDICINAL

PLANT
RIGHT DOSE
Empirical herbs depends on peoples tradition like
the numbers of use of leaf, stem, or root in making
medicinal herbs
The product made by manufacturer should be
consumed in a right dose as its written on the back
of the products side

RIGHT TIME

Irritating-stomach Herbs should be taken after a

meal
e.g: Rosella tea, morinda, ginger, garlic, orange,
andrographis
paniculata, chili
Herbs that reduce uterine contraction like cabai
jawa (Piper retrofractum) should not be used in the
late pregnancy

 RIGHT ROUTE OF USE

Herbs like cajuput oil should be used externally
Datura metel Leaf (kecubung) should be smoked for
asthmatic patient

RIGHT PATIENTS
Most of medicinal plant like chemical drug must be
used carefully for the pregnant, lactating women

RIGHT INDICATION
Catharantus roseus (Tapak dara) could reduce
numbers of leucocyte in blood

MEDICINAL PLANT
CHARATERISTIC
COMPLEMENTARY EFFECT
Thyme (Thymus vulgaris) contains thymol,
calvacrol, and polymethoxyflavon
* Thymol acts as an expectorant
* Calvacrol acts as an antibacterial
* Flavon enhances immune system

SYNERGIC EFFECT
Misai Kucing (Orthosiphon stamineus) contains
polymetoxyflavon, saponin, potassium that
synergicly act as diuretic

 ANTAGONISTIC EFFECT
Tobacco leaf (Rheum officinale) contains anthraquinone
as laxans but also contains tannin as an antidiarrhea

SIDE EFFECT ELIMINATING SUBSTANCES (SEES)

Sugar cane (Saccharum officanarum L) that produces
sugar contains Sacharant as an anti diabetic

INTERACTION BETWEEN MEDICINAL

PLANT AND CHEMICAL DRUG
ACTION ON P450
Hypericin, Garlic, Ginseng, Silymarin, Melatonin

ACTION ON CYP3A4 and CYPP2O6

Curcuma heyneana, Piper nigrum, Punica granatum,
Catharantus roseus, Piper cabeba, Alyxia reinwardtii,
andrographis paniculata, Cymbopogon nardus,
Glycyrrhiza glabra, Rheum palmatum, Santalun album,
Syzygum aromaticum, Tinospora crispa, Alstonia
scholaris, Zingiber aromaticum

SYNERGIC EFFECT
Misai Kucing/ Kumis Kucing (Orthosiphon
stamineus) contains polymetoxyflavon, saponin,
potassium that synergicly act as diuretic

SIDE EFFECT OF HERBAL

MEDICINE
1. GASTROINTESTINAL

Stomachache
Diarrhea
Nausea
Vomiting

2. NERVE SYSTEM

Headache
Dizziness
Insomnia
Sleepy

3. CARDIOVASCULAR SYSTEM

Increasing or decreasing of blood pressure

Palpitation
Syncope
Cold sweat

4. ALLERGIC REACTION
Anaphylactic
Urticaria
Steven Johnson Syndrome

5. METABOLISM
Drop of glucose level in blood

DAFTAR TANAMAN OBAT PROSPEKTIF UNTUK

FITOFARMAKA
N
O

Nama Tanaman

Bagian

Indikasi Potensi

1.

Garlic (Alium savitum)

Umbi lapis

Candidiasis, hyperlipidemia

2.

Benalu Teh (Loranthus spec)

Batang

Megarah ke antikanker

3.

Brotowali (Tinospora rumphii)

Batang

Antimalaria, diabetes

4.

Ceguk (Quisqualis indica)

Biji

Askariasis, oksiuriasis

5.

Daun ungu (Graptophylum pictum)

Daun

Haemorrhoid

6.

Delima putih (Punica granatum)

Kulit buah

Antiseptik. Antidiare

7.

Dlingo (Acorus calamus)

Rimpang

Sedativa

8.

Inggu (Ruta graveolens)

Daun

Analgetika, antipiretika

9.

Jahe (Zingiber officinale)

Rimpang

Analgetika, antipiretik,
antiinflamasi

10
.

Jambu biji (Psidium guajava)

Daun

Antidiare, DBD

11
.

Jambumede (Anacardium occidentale)

Daun

Analgetika

12
.

Jati belanda (Guazuma ulmifolia)

Daun

Hiperlipidemia

DAFTAR TANAMAN OBAT PROSPEKTIF UNTUK

FITOFARMAKA
N
O

Nama Tanaman

Bagian

Indikasi Potensi

16
.

Kumis kucing (Ortosiphon stamineus)

Daun

Diuretika

17
.

Kunyit (Curcuma domestica)

Rimpang

Hepatitis, artritis, antiseptik

18
.

Labu merah (Cucurbita moschata)

Biji

Taenasiasis

19
.

Pegagan (Centella asiatica)

Herba

Diuretika, antiseptik, antikeloid

20
.

Pala (Myristica fragrans)

Buah

Sedativa

21
.

Pare (Momordica charantia)

Buah/ biji

Diabetes

22
.

Pepaya (Carica papaya)

Getah, daun,
biji

Sumber papain, antimalaria

23
.

Saga telik (Abrus precatorius)

Daun

Stomatis, aftosa

24

CAUTIOUSLY SIDE-EFFECT
HERBS

No
.

1.

Organ Affected

Herbs

Heart

Digitalis leaf, Oleander leaf

2.

Autonomous nervous system

Datura metel (kecubung), Saga

seed,
Jatroba seed

3.

Central nervous system

Cocaine leaf

4.

Digestive system

Widuri leaf

5.

Repiratory system

Cashew skin

6.

Female reproduction system

(Abortivum)

Maja leaf, Kelor root, young

pineaple,

Male reproduction system

- Decrease libido: cotton seed

- weakens spermatozoa: Pare
seed

8.

Urethra

- Strong diuretic: Meniran,

kejibeling
- Renal stone: Spinach,
Pineapple

9.

Liver

Comfrei, mimba and fermented

alcohol

7.

10 Increasing level of uric acid in

Beans

HERBS THAT HAVE NARROW

LD50
NO

RAW HERBS

FAMILIA

LD50

1.

Daun Majakan
(Quercus lucitanica Roxb.)

Fagaceae

16,45
mg/kgBB

2.

Bunga Nagasari
(Mesua ferea L.)

Guttiferae

20,93
mg/kgBB

3.

Buah sukmadiluwih
(Gunera macrophyla Bl.)

Halorrhagidac
eae

21,91
mg/kgBB

4.

Bunga Sidowayah
(Woodfordia floribunda)

Litraceae

24,22
mg/kgBB

5.

Kulit buah delima

(Punica granatum L.)

Punicaceae

29,0 mg/kgBB

Various of Medicinal Plant

used for Doctors

 Immunomodulator: Meniran, Lidah buaya,

Sambiloto, Temulawak
Anti-Inflammation : Temulawak,
Lempuyang, jahe, Lengkuas
Anti-Parasite : Leuchena leucocephala,
Tinospora (brotowali), Temuireng for
treating:
Brugia malayi, Brugia timori, Wuchereria
bancrofti
Anti-viral : Meniran, Pasak Bumi, Beluntas,
dan Jambu Biji

 Anti-biotic : Meniran, Beluntas, Lengkuas dan

Tabat Barito,
Anti Hypercholesteremia : Labu Siam, Temulawak,
Salam, Kunyit, Sambiloto, dan Mengkudu
Anti Hypertension : Belimbing Wuluh, Seledri,
Garlic, Leunca, Kayu Manis, Rosella, Pegagan
Anti Oxydant : Temulawak, Cabai, Buah
Mengkudu, Lengkuas, Daun Salam, Teh, Lada
Hitam
Diabetes mellitus : Pare, Salam, Jamblang, Kayu
Manis, Brotowali, Mengkudu, Sambiloto, Kunyit

 Uric acid: Sidaguri, Anting-anting, Kepel, Salam

Fever : Sambiloto, Pule, Temulawak
Tooth ache : Cengkeh, Jambu Mede
Obesity : Kemuning, Gamboge, Jati Belanda
Anorexia : Lempuyang wangi, temulawak, temu
mangga, temu ireng, temu kunci

 Nephrolithiasis: Tempuyung, keji beling, Meniran,

Sembung
Dyspepsia : Pare, Pala, Jahe, Temulawak, Kunyit
Nausea & vomitting : Jahe , ketumbar
Cancer palliative & supportive : Sirsak, pegagan,
kunyit putih, sambiloto, ceplukan, manggis, keladi
tikus
Heart & Vascular disease : Pegagan, garlic, dewa,
temulawak, kunyit

 Gastritis: Kunyit, Temulawak, Pegagan

Arthritis : Cabe, Sereh, Kayu putih, Cengkeh,
Jahe, Temulawak, Tapak liman, salam
Constipation: Lidah buaya, senna, wungu
Cough: Saga, Adas, Kencur, Jahe
Gastroentritis: Jambu biji, Tapak liman,
Sambiloto
Insomnia: Pala, Valeria

 Hepatoprotector: Temulawak, Paliasa, Kunyit,

Meniran, Sambiloto
Erectile dysfunction : Purwoceng, Som jawa,
Cabe jawa
Hemorrhoid: Wungu
Upper Respiratory Tract Infection: Adas,
Sambiloto
Skin disease: Lengkuas, Ketepeng Cina,
Pegagan

REGULATION

The Core PROGRAM

Implementation of MoHs Decree No 3/2010 regarding
Jamu Scientification + No. 1109/2007 regarding CAM
practitioner leading to Govt Regulations draft of
Trad.Med (as mandatedby Health Act No 36/09) +
revitalization of SP3T
SJ DIAGNOSTIC : down-stream approach by
developing dual JAMUs skilled researcher +
practitioner (physician+dentist) + scientific labeling
of JAMU MEDICAL ("concentrate")
SJ THERAPEUTICALS : "up-stream approach by
developing community/clinical pharmacist + JAMUs
producer using local wisdom potency
Escorted by the National Commission and Regional
Commission of SJ
Central Java as a pioneer model

Dasar yuridis (UU KES baru)

OT = bag sediaan farmasi (ttp khusus)

ps 1(4)
Obat tradisional adalah bahan atau
ramuan bahan yang berupa bahan
tumbuhan, bahan hewan, bahan
mineral, sediaan sarian (galenik), atau
campuran dari bahan tersebut yang
secara turun temurun telah digunakan
untuk pengobatan, dan dapat
diterapkan sesuai dengan norma yang

Dasar yuridis yankestra

Pelayanan kesehatan tradisional adalah

pengobatan dan/atau perawatan dengan cara
dan obat yang mengacu pada pengalaman
dan keterampilan turun temurun secara
empiris yang dapat dipertanggungjawabkan
dan diterapkan sesuai dengan norma yang
berlaku di masyarakat ps 1 (16)
Ps 48 : yankestra = salah satu upaya kes
Jamu : salah satu ramuan yankestra (ps 59
-1.b) yg hrs AMAN & MANFAAT n memerlukan
PP

Yankestra (2)
Orang (Dr/Non Dr) yankestra pakai alkestek
perlu ijin dinkes (ps 60) perlu standar
tindakan yankestra
Masyarakat blh meningkatkan yankestra via
a.l. Rumah Sehat (ps 61)
BB TOOT jamin bahan baku OT (ps 100 ay 1)
GP Jamu atas dasar PP membuat JAMU
MEDIK/konsentrat = sbg sediaan farmasi
utk kuratif sbg sinergi/integrasi yankes formal
(SELAIN JAMU NON MEDIK/OTC utk promotifpreventif-rehab)

INDONESIAN JAMU Practitioners &

Health Act 36/2010
JAMUs Dr use empirical - rational herbs (art. 104
para 2) TRAD.HEALTH standards
Competence based of professionalism : using JAMUs
research method : qualitative method =/> quantitative
(Art 105) 50 HOURS special TRAINING (Permenkes SJ
No 3/2010)
Trad.Health Standard ethicolegal approach by
establishing specific subdivisions in MKEK IDI leading
to forming JAMUs College recoqnized by KKI
Advocating the establishing : THE BOARD OF LECTURER
as college of JAMUOLOGI by IDI / PDGI after CAM EB
of IDI
Making JAMU Medical/concentrates led by
clinical/community pharmacist (art. 108) supported by
JAMU MANUFACTURER as partner of network of DUAL-

REVITALIZATION

KOMNAS
SJ

YANMED
HOSPITAL
SENTRA
P3T

Medicina
l
Materials

GP

FARMASI

Metode Riset

Kuali

INDIVIDU

BINKES

GP
JAMU

MetasintesisDeskriptifexploratif

Clin Trial

kuanti

IAI

Prevent
Infection

Preventive

Label Saintifik

PUBLIC HEALTH

PUBLIC HEALTH
Meta-analysis

IDI
PDGI

Physician/dentist

Dual Clinics Network

Res through Services

Hierarchy of health worker

GRAND
DESIGN
S.J. NAS

OTONOM

INTEGRASI
FASYANKES
JAMU for FITNESS Kohort prospektifRPP BATTRA
AESTHETICs JAMU
Mass
Clinical
observation
ANTI-AGINGs JAMU
BATTRA

Synergizing & Integrating TRAD.MED. into

Formal Health care System
Jamu Medik/Concentrate
FITO
FARMA
KA

OHT

Jamu saintifik Nas Jamu Saintifik Lokal

Indigenous
Formal Health
Health Care
Care System
System
(Jamu)
JAMKESDA ??

JAMKESMAS

Folk Health
Care System
JAMU NON MEDIK/OTC

JAMU SCIENTIFICATION NETWORK of dualprofession : JAMU researcher + practitioner

and SCIENTIFIC LABELIZATION of MEDICAL
JAMU + NON MEDICAL JAMU

35

JAMUS DR : BROAD-MINDED & PROFESSIONAL

BATTRA

CAM

MUDAH dan MURAH

IDI / PDGI AREA SHOULD HORIZONS

& CARE OF INTEREST NATION

Biomedik

Contextual features
Patients preference

Diluar ilmu Kedokteran

Dan Keperawatan
Belum diakui
Hereditary = peer
review Doctor herbal
researcher

KONVENSIONAL

REHABILITASI
GOLDEN STANDARD
FITOFARMAKA

PREPATOGENESIS

JAMU

HERBAL
Terstandar

Quality of Life

Patologi = Konvensional

PALIATIF
HOME CARE

BATTRA SALAH SATU UPAYA KES ps 48 UU Kes no 36/09

Tata cara & jenis = RPP Battra (ps 59)

Integrasi Yankes
Penyatuan/penggabungan sebagian
atau seluruh aspek pengobatan
komplementer-alternatif pada
pelayanan kesehatan di semua
tingkatan fasilitas pelayanan
kesehatan, termasuk aspek regulasi,
pembiayaan, serta kebijakan
mengenai penyelenggaraan
pelayanan dan obat yang
digunakan.

Pasal 1- butir 8 Permenkes 1109/2007

ET YAN-LITBANG : PERLU DR/G & NAKES BERWAWASAN LITBANG

Sinergi yankes ps 1-7 Permenkes

1109/07

Penggabungan metoda
pengobatan non konvensional
dengan pengobatan konvensional
yang akan memberikan
manfaat/khasiat pengobatan yang
lebih baik dibandingkan dengan
manfaat satu jenis pengobatan
mplisit : multi-metodologi dlm litbang pendampingan dlm yankes (integrasi)
saja.
uga : KE-JANGAN-SOMBONG-AN kedokteran konvensional

Principles of SAINTIFIKASI
JAMU
PERMENKES 3/2010
& 1109/2007

Getting JAMUs scientific evidences among skilled and

practicing doctors (and dentists) as the noble & oathtaking professions, as the complementary & alternative
medicine for promotive, preventive, rehabilitative,
palliative remedies and finally curative as well at
formal health care facilities.
Networking dual function practitioners : research
through service in various JAMU clinic at primary and
secondary care facilities.

Sentra P3T (as dev & implementing

clinic of trad.med) Permenkes 584/95
Screening, doing research of trad.meds
herbs material (JAMU) NIHRDs
function
Educating & training the safe & effective
JAMU BPSDMs function
Providing JAMU as approved model
DG of Medical Services
Fitofarmakas clinical trial NIHRDs
function

Standar
Rumah
Sakit

Ruma
h
Sakit

Rumah
Sakit
Mitra

Dokter Umum
Konvensional
Dual research-service =
Double ID-board

Unit Teknis Sentra P3T

BP, PUSKESMAS, RS, SWASTA

BKTM & LKTM

Ris

jamu
Manufacture
r

et

Penelitian
pelayanan

Holisti
k

BBTOOT TIPE A
Prakti

si Jamu

Komite
Ilmiah
Komite
etik

Rumah Sehat
Tradisional/
CAM
Dokt
er
Non
Dokter/
SP3T
Self
Treatment

Dokt
er
Non
Dokter/
SP3T
Self
Treatment

MEDICAL-JAMU R & D System Based on Health Services Permenkes 3 / 10

BK-KA IDI +
BALITBANG

SJ
METPEN
NETWORK

50 jam

DOUBLE ID BOARD

ETIKOLEGAL - PROFESIONALISM
PATOLOGIK
D/ KLINIS
TH/ KLINIS

HOLISTIC MR

THERAPI HOLISTIK
DIAGNOSTIK HOLISTIK
FISIKMENTALSOSIO

SPIRI
TUAL

LEVEL
LINGK
INDEP

100 jam
BK-KA IDI + MKEK
PSIKONEUROIMUNOENDOKRINOLOGI
ANATOMI

FISIOLOGI

BIOLOGI

BIOKIMIA

KIMIA

HISTOLOGI

FISIKA

KEBUGARAN
Wellness
Index

Konsep Diklat SJ 50 jam awal Sinergi

Praktek Konvensional Non Konvensional
PRAKTISI KRITIS +
.
BLOK 1
METODOLOGI PENELITIAN

BLOK 2
DIAGNOSTIK HOLISTIK

DOKTER
SJ

SAINTIFIKASI DR JAMU
(LANGKAH AWAL NAKES JAMU)

JEJARING PENELITI

BLOK 3
FARMAKODINAMIK JAMU
SAINTIFIKASI JAMU
(OBAT TRAD BRAND RI)

BLOK 4
MEDIKO-ETIKOLEGAL
PRAKTISI LEGAL PROFESIONAL

Persyaratan Perizinan
Jenis

Registrasi
Nakes

Izin Nakes

Dokter-dokter
gigi, apoteker

STR/STRA

SIP

SBR-TPKA

ST-TPKA

Tenaga
kesehatan
lainnya

SURAT
IZIN
/REGISTRASI
(DINKES
PROV)

SIP/SIK

SBR-TPKA

STTPKA/SIKTPKA

Batra (jamu)

Registrasi
KomplementerAlternatif

Surat Terdaftar
Batra di Dinkes
Kab/Kota

Surat
Tugas/Surat
Izin Kerja
Komplement
er-Alternatif

5 April 2010
KUNJUNGAN IBU SIKIB & PDHMI KE TAMAN HERBALIA

5 April 2010

SIRIH MERAH UNTUK CA MAMMAE

Indonesia Hijau

2013

Indonesia Sehat

THANK
YOU

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