Several concerns

Throw your old code out of the window and try to get this one to work…

import wixData from 'wix-data';

//-------------------------USER-INTERFACE-----------------------------------------------
const DATABASE = "Listepraticiens"; //<-- Paste in here the ID of your DATABASE!
const DB_FIELD1 = "region";         //<-- Paste in here the ID of the Database-Field-1!
const DB_FIELD2 = "departement";    //<-- Paste in here the ID of the Database-Field-2!
const ddn1 = "#dropdownReg";        //<-- Here the ID of your Dropdown-1.
const ddn2 = "#dropdownDep";        //<-- Here the ID of your Dropdown-2.
//-------------------------USER-INTERFACE-----------------------------------------------

$w.onReady(async()=>{console.log("Page is ready...");
    //Loading dropdown-1 immediately when page is ready...
    let itemData = await get_ItemData(); 
    console.log("Item-Data: ", itemData);
    create_UniqueDropdown(itemData, DB_FIELD1, ddn1);

    //The user clicks on the dropdown-1 and choose a REGION.
    //This will affect on dropdown-2 and fill it with unique-values.
    //Regarding the choice taken on dropdown-1.
    $w(ddn1).onChange(async()=>{
        let itemData = await get_ItemData(); 
        create_UniqueDropdown(itemData, DB_FIELD2, ddn2); 
    }); 
    $w(ddn2).onChange(async()=>{
        //????????????????????????
        //CONTINUE...............
        //Write your code here......
        //What should happen next when changing ddn-2???
        let items = await startSearchEngine();
        console.log("HURAY --> !!! " + items);
        if (items[0]) {
            $w('#nbrpraticiens').text = `${total} praticiens trouvés`;
            $w('#nbrpraticiens').show();
        }
        if (total === 1) {
            $w('#nbrpraticiens').text = `${total} praticien trouvé`;
            $w('#nbrpraticiens').show();
        }
        if (total === 0) {
            $w('#nbrpraticiens').text = "Nous n'avons pas encore de praticien dans ce secteur";
            $w('#nbrpraticiens').show();
        }
    }); 
    $w("#pagination1").onChange(()=> {$w("#haut").scrollTo();});
});

function get_ItemData() {
    let QUERY = wixData.query(DATABASE);
    QUERY.limit(1000)
    QUERY.find()
    .then((res)=> {console.log(res);
        if (res.totalCount>0) {
            let itemData = res.items; 
            return itemData;
        }
        else {console.log("No DB-Entries found!");}
    }).catch((err)=>{console.log(err);});
}

function create_UniqueDropdown(items, dbfield, dropdown) { 
    const uniqueTitles = getUniqueTitles(items); 
    $w(dropdown).options = buildOptions(uniqueTitles); 
    function getUniqueTitles(items) {
        const titlesOnly = items.map(item => item[dbfield]); 
        return [...new Set(titlesOnly)];
    }
    function buildOptions(uniqueList) {
        return uniqueList.map(curr => {
            return {
                label:curr, value:curr
            };
        });
    }
}

function startSearchEngine() {
    wixData.query(DATABASE)
    .limit(1000)
    .contains('departement', String($w('#dropdowndep').value))
    .eq("region", String($w('#dropdownreg').value))
    //.ascending("_random")
    .find()
    .then((res)=>{console.log("My found RESULTS: ", res);
        if (res.totalCount>0) {let items = res.items;
            console.log("Items: ", items);
            return items;
        }
        else {console.log("No RESULTS found!!!");}
    })
    .catch((err)=>{console.log("We have a problem ! ---> " + err);});
}

You will need…

  1. 2x Dropdowns (“dropdownReg” + “dropdownDep”)
  2. 1x Your database —> “Listepraticiens”
  3. 2x The database-fields you are using for your dropdowns (“region”/“department”)
  4. You do not need a dataset in this version. Disconnect your dropdowns from your dataset.
    Your dropdowns should be filled automatically and directly from the DATABSE.

This code-line:

//.ascending("_random")

Where did you get it from ???
It is deactivated.

Further:
If you want to connect a repeater to show results, you will have to code it (expanding your code).

Also take a look onto all the given CONSOLE-LOGS, which will help you to bring this CODE to → WORK!

And for more informations, read this post…

Now you should be able to understand what you are doing and be able to generate your wished functionality.

And this one…