To observe the curative effect of Chaigui Wendan Dingzhi Decoction on cognitive impairment and depressive mood in elderly patients after stroke, and to explore its mechanism. Methods:From March 2015 to March 2017, 150 elderly patients who were diagnosed as stroke were randomly divided into control group and observation group. PQRS, MMSE and HAMD were measured before and after treatment, and PI3K, AKT, pAKT, Bcl and Bax concentration in cerebrospinal fluid were measured at different time points before and after treatment. Results:1)PQRS score and MMSE score were not comparable before treatment (P>0.05), but the scores of the three days and one week after treatment were lower than those before treatment. The observation group was more significant (P<0.05). 2)Before treatment, the HAMD score of the two groups was not comparable (P>0.05). After treatment, HAMD scores of two groups were reduced, but the observation group was more significant (P<0.05). The difference was statistically significant (P<0.05). 3)Compared with before treatment, the levels of PI3K, pAKT and bcl of two groups at any time point were decreased (P<0.05), while the level of bax was increased (P<0.05). The control group was more significant in changing trend of PI3K/AKT signal pathway marker protein than observation group (P<0.05). 4)After treatment, the effective rates of the two groups were: observation group 90.15%, control group 79.89% (P<0.05), and the difference was statistically significant. The observation group had better results than the control group. Conclusion:Chaigui Wendan Dingzhi decoction has a significant effect on the recovery of cognitive function and depressive mood in stroke patients after stroke, which may be related to the activation of PI3K / AKT signaling pathway.