Three-leaf akebia (Akebia trifoliata), known as "mutong" in traditional Chinese medicine (TCM), has been used historically as a diuretic and to promote the flow of water in the body, which underpins its traditional use for conditions such as edema (fluid retention). Ancient TCM texts describe its use for "drainage of dampness" and relief of "water swelling," terms that broadly correlate to modern understandings of edema. The plant’s stem is most commonly utilized, often prepared in decoctions with other herbs for synergistic effects.

Despite this long history of use, modern scientific research has not robustly validated these effects in high-quality clinical trials. Limited animal studies and in vitro experiments suggest some diuretic activity, but the evidence is not strong or consistent enough to confirm efficacy or safety in humans. Most references to Three-leaf akebia’s use in edema are found in traditional pharmacopoeias and herbal compendiums, not in peer-reviewed scientific literature. Thus, while its application is well-established in TCM practice for mild edema and urinary difficulties, scientific evidence remains insufficient.

In summary, the use of Three-leaf akebia for edema is primarily justified by traditional usage, with modest supporting evidence from preclinical studies, but lacking rigorous scientific validation.