Abstract: At present, clinical treatment of hemifacial spasm by traditional Chinese medicine mostly starts from wind, which is divided into internal wind and external wind. The therapeutic methods mainly include dispelling wind and relieving spasm, calming the liver and subduing yang, nourishing yin and blood, activating blood and dredging collaterals, and calming the liver and extinguishing wind. Based on the Xuanfu theory, the core pathogenesis of hemifacial spasm is systematically elucidated as obstruction of facial Xuanfu leading to impaired circulation of qi, blood, body fluids, and mental activities. Dynamically integrating the pathological states of Xuanfu, namely “stagnation-obstruction-atrophy,” a syndrome differentiation and treatment system of “three stages and four syndromes” is constructed, and the three therapeutic methods of “diffusing, dredging, and nourishing” are established. Wind medicinals are consistently used as the core drugs throughout the entire treatment process to achieve the goal of opening Xuanfu and relieving spasm.

Key words: hemifacial spasm, Xuanfu theory, wind medicinals, opening the Xuanfu and relieving spasm, syndrome differentiation and treatment