By analyzing urinary metabolic profiles of heat-phlegm obstructing lung syndrome and non-heat-phlegm obstructing lung syndrome in children with exacerbated asthma to explore potential metabolic biomarkers between different syndromes.Methods:Twenty-four sick children with Heat-phlegm obstructing lung syndrome and twenty sick children with non-heat-phlegm obstructing lung syndrome were enrolled.Urine samples were collected，and urine metabolites profiles were analyzed by LC-MS coupled with a suite of statistical analyses.Results:Clear separations between heat-phlegm obstructing lung syndrome and non-heat-phlegm obstructing lung syndrome existed.Differential metabolites and several metabolic pathways related organic acids，amino acids，fat，ketone compound were identified.Compared with heat-phlegm obstructing lung syndrome group，the levels of organic acids，amino acids，fat，ketone compound were upregulated，such as methionine，succinic acid，lysine，creatine，kynurenine，and cyclic AMP，and only hydroxy indole acetaldehyde were down in urine with non-heat-phlegm obstructing lung syndrome.Furthermore，five abnormal metabolic pathways，such as biotin metabolism，tryptophan metabolism were identified.Conclusion:The basis of metabolic biomarkers and pathways in children with bronchial asthma exists in different syndrome types，which may be the essence of different TCM syndromes.