Abstract：Perianal abscess is primarily caused by downward infusion of damp-heat and toxin accumulation due to blood stasis，often progressing to ulcerative fistulas that consume qi and damage blood．The core pathogenesis involves dysfunction of the opening-closing of sweat pore and disordered qi-fluid metabolism． Guided by the dynamic perspective of the "sweat pore-qi-fluid" theory， this study analyzes the pathological evolution of perianal abscess， establishes a stage-specific treatment system，in which the main treatment is to unblock sweat pore and restrain toxin at mass stage，to open xuanfu to rupture abscesses at suppuration stage，and to regulate sweat pore and reinforce healthy qi at ulceration stage．Therapeutic approaches include therapy of circling sore with wet powdered medicine to regulate sweat pore opening-closing and intercept disease progression at mass stage， toxin-expelling and suppurationpenetrating therapy to restore qi-fluid transport channels at suppuration stage，and suppuration-promoting and fleshregenerating therapy and sweat pore-regulating and healthy qi-reinforcing therapy to repair the sweat pore microenvironment at ulceration stage． This achieves sequential treatment through dynamic regulation of sweat pore opening-closing and restoration of qi-fluid metabolic balance， providing theoretical and practical references for optimizing traditional Chinese medicine management of perianal abscess.