Your question is a bit vague, but I will try to guess at what you mean.

• You want to clear tables before loading them with data?
  Depending on your permissions to the DB, 'TRUNCATE TABLE' followed by 'INSERT' will be the fastest. 'DELETE FROM' works, but is slower as it gets logged. This will preserve the table design, while clearing its contents.
  
• You want to remove a table and recreate it with new rules?
  I would examine 'ALTER TABLE', which will probably do what you need. If it doesn't, your only real option is 'DROP TABLE' followed by 'CREATE TABLE'
  
• You want to create a table from data that's already in the database?
  I suggest researching 'SELECT ... INTO' syntax.
  

You probably are looking for a pure-SQL solution, in which case your question is a bit off-topic. However, if you are looking for ways to implement SQL Server access without having to learn SQL, DBIx::Abstract is a good place to start. There are several other modules that perform abstraction also available on the CPAN.

If it is just SQL you're after, drop me a private message and I will see if I can help.