To explore the effects of PI3K/AKT signaling pathway on postoperative cognitive impairment(POCD).Methods:A total of 2 patients under surgical anesthesia admitted to anesthesia department Affiliated Hospital of Shandong Academy of Medical Sciences from Feb.2018 to Jun.2019 were selected as the research objects and were randomly divided into a control group and an observation group,with 46 cases in each group.The control group(n=46)was given routine perioperative treatment，and the observation group(n=46)was given Sini Decoction orally.The changes of miscellaneous inflammatory factors，simple mental state scale，PI3K/AKT pathway and vital signs in different periods were observed and compared.Results:Immediately after insertion of laryngeal mask(T1)，6 h(T2)，24 h(T3)，48 h(T4)were significantly lower than T0 at PI3K and AKT，while Bcl and Bax were significantly higher than T0(P<0.05)，and the observation group was better than the control group(P<0.05).The levels of IL-6，TNF-alpha and CRP in control group increased significantly 24 h and 5 d after operation(P<0.05)，while the levels of IL-6，CRP and TNF-alpha in observation group increased significantly 24 h after operation(P<0.05).The observation group was better than the control group at 24 hours and 5 days after operation(P<0.05).In the control group，5 days after the operation，computing power and attention，delayed recall，reading and language comprehension，and total scores were significantly lower than those before the operation(P<0.05).However，there was no statistically significant difference between the study 5 days after the operation and before the operation(P>0.05).The observation group's calculation ability and attention，delayed recall，reading and language comprehension，and total scores were significantly better than those of the control group on the 5th day after surgery(P<0.05).The systolic and diastolic blood pressure of the 2 groups of T1 were significantly lower than that of T0 and T2(P<0.05)，but there was no significant difference between the 2 groups of T0，T1，and T2(P>0.05).Conclusion:Sini Decoction can improve POCD by affecting PI3K/AKT signaling pathway and inhibiting inflammation.